Abstract: Mobile Ad hoc network is a collection of nodes which tries to communicate each other without any fixed infrastructure. In this network, nodes can move freely and dynamically from self-organized into arbitrary topologies. Due to self-organizing, the network is vulnerable to attack by distributed denial of service who attempts to gain unauthorized access and damage data on communication medium by denial the service. This research study focuses on medical hospital, which is relay on MANET topologies for transmitting of medical images. Transmitting of medical images from source to destination is one of the greatest challenges because the image should reach the destination without disturbances like delay, packet loss and disturbances from Denial of service attackers, intruder, etc. Adhoc On-Demand Distance vector protocol is designed for transmitting of medical images by finding a new route when it’s needed. Even though this protocol is creating a path on demand, protocol functionalities has limitations on route redirection, security and energy consumption. This research study is working to develop an algorithm to identify the Denial of service attacks who is playing the role of delaying the packets to the next hop, so that the emergency medical images transmission is gets delayed, as well as achieving the denial of service in on time in the network. The algorithm uses directional antenna transmission to optimize the energy consumption as energy factor is an important challenge in MANET. The developed protocol is named as directional advanced intruder handling Ad hoc on demand distance vector protocol (directional advanced intruder handling ad hoc on demand distance vector). The algorithm are simulated in NS2 and compared with Ad hoc on demand distance vector protocol. The result of analysis shown, proposed research algorithms performed 50% better than AODV protocol.