An ECG data compression algorithM using max-min slope update is proposed and a real time 3 channel ECG transmission system is implemented using the proposed algorithm. In order to effectively compress ECG data, we compare a threshold value with the max-min slope difference (MMSD) which is updated at each sample values. If this MMSD value is smaller than the threshold value, then the data is compressed. Conversely, when the MMSD value is larger than threshold value, the data is transmitted after storing the value and the length between the data which is beyond previous threshold level. As a result, it can accurately compress both the region of QRS, P, and T wave that has fast-changing and the region of the base line that slope is changing slow. Therefore, it Is possible to enhance the compression rate and the percent roms difference. In addition, because of the simplicity, this algorithm is more suitable for real-time implementation.