diff --git a/CHANGELOG.md b/CHANGELOG.md
index 69e5910..fccda78 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -14,6 +14,7 @@ and **Merged pull requests**. Critical items to know are:
 Referenced versions in headers are tagged on Github, in parentheses are for pypi.
 
 ## [vxx](https://github.com/pydicom/deid/tree/master) (master)
+- Add 'clean-pixel' CLI command [#285](https://github.com/pydicom/deid/pull/285) (0.5.0)
 - Fix REMOVE action to respect REPLACE or JITTER priority [#283](https://github.com/pydicom/deid/pull/283) (0.4.6)
 - Add enhanced private tag syntax support [#282](https://github.com/pydicom/deid/pull/282) (0.4.5)
 - Fix tag specification for KEEP action [#281](https://github.com/pydicom/deid/pull/281) (0.4.4)
diff --git a/deid/dicom/pixels/clean.py b/deid/dicom/pixels/clean.py
index 9622a59..4606e97 100644
--- a/deid/dicom/pixels/clean.py
+++ b/deid/dicom/pixels/clean.py
@@ -132,7 +132,7 @@ def get_figure(self, show=False, image_type="cleaned", title=None):
                 plt.show()
             return plt
 
-    def _get_clean_name(self, output_folder, extension="dcm"):
+    def _get_clean_name(self, output_folder, extension="dcm", prefix="clean-"):
         """
         Get path to a cleaned output file.
 
@@ -145,6 +145,10 @@ def _get_clean_name(self, output_folder, extension="dcm"):
         exist.
         extension: the extension of the file to create a name for, should
         not start with "."
+        prefix: string prepended to file's basename
+        extension: extension to append to basename after removing .dcm or .dicom.
+                   Use empty string to disable. .dcm|.dicom will not be stripped. basename is not changed.
+
         """
         if output_folder is None:
             output_folder = self.output_folder
@@ -153,8 +157,16 @@ def _get_clean_name(self, output_folder, extension="dcm"):
             bot.debug("Creating output folder %s" % output_folder)
             os.makedirs(output_folder)
 
-        basename = re.sub("[.]dicom|[.]dcm", "", os.path.basename(self.dicom_file))
-        return "%s/cleaned-%s.%s" % (output_folder, basename, extension)
+        # do we want to change extension? this might convert .dicom to .dcm
+        # or would add .dcm to eg. 'MR.*' (MR.12*34.dcm) or '*IMA' (1234.IMA.dcm)
+        if extension:
+            basename = re.sub("[.]dicom|[.]dcm", "", os.path.basename(self.dicom_file))
+            extension = "." + extension
+        else:
+            basename = os.path.basename(self.dicom_file)
+
+        new_basename = prefix + basename + extension
+        return os.path.join(output_folder, new_basename)
 
     def save_png(self, output_folder=None, image_type="cleaned", title=None):
         """
@@ -233,26 +245,47 @@ def animate(i):
         else:
             bot.warning("use detect() --> clean() before saving is possible.")
 
-    def save_dicom(self, output_folder=None, image_type="cleaned"):
+    def save_dicom(
+        self, output_folder=None, prefix="clean-", extension="dcm"
+    ) -> str | None:
         """
         Save a cleaned dicom to disk.
+        DicomCleaner object must have already been run through detect() and clean()
+
+
+        Parameters
+        ==========
+        output_folder: where to save clean dicoms. Will use self.output_folder if None
+        prefix: passed onto py:meth:`DicomCleaner._get_clean_name`.
+                Default adds 'clean-' to basename
+        extension: paseed onto py:meth:`DicomCleaner._get_clean_name`.
+                   Default appends .dcm after removing .dcm or .dicom.
+                   use empty string to disable, reuses whole basename
+
+
+        Returns
+        =======
+        dicom_name: the file that was written
 
-        We expose an option to save an original (change image_type to "original"
-        to be consistent, although this is not incredibly useful given it would
-        duplicate the original data.
         """
-        # Having clean also means has dicom image
-        if hasattr(self, image_type):
-            dicom_name = self._get_clean_name(output_folder)
-            dicom = utils.dcmread(self.dicom_file, force=True)
-            # If going from compressed, change TransferSyntax
-            if dicom.file_meta.TransferSyntaxUID.is_compressed is True:
-                dicom.decompress()
-            dicom.PixelData = self.cleaned.tobytes()
-            dicom.save_as(dicom_name)
-            return dicom_name
-        else:
-            bot.warning("use detect() --> clean() before saving is possible.")
+        if not hasattr(self, "cleaned"):
+            bot.warning(
+                "No cleaned data for '%s'. use detect() --> clean() before saving is possible."
+                % (self.dicom_file)
+            )
+            return
+
+        dicom_name = self._get_clean_name(
+            output_folder, prefix=prefix, extension=extension
+        )
+        dicom = utils.dcmread(self.dicom_file, force=True)
+
+        # If going from compressed, change TransferSyntax
+        if dicom.file_meta.TransferSyntaxUID.is_compressed is True:
+            dicom.decompress()
+        dicom.PixelData = self.cleaned.tobytes()
+        dicom.save_as(dicom_name)
+        return dicom_name
 
 
 def clean_pixel_data(
diff --git a/deid/main/__init__.py b/deid/main/__init__.py
index bf6cc1a..5604899 100644
--- a/deid/main/__init__.py
+++ b/deid/main/__init__.py
@@ -18,7 +18,7 @@ def get_parser():
         description="Deid (de-identification, anonymization) command line tool."
     )
 
-    # Global Variables
+    # Global Variables: generic options available for all 'actions' command
     parser.add_argument(
         "--quiet",
         "-q",
@@ -70,22 +70,58 @@ def get_parser():
         action="store_true",
     )
 
+    # Additional args specific to distinct commands (see args.command conditions)
     subparsers = parser.add_subparsers(
-        help="action for deid to perform",
-        title="actions",
-        description="actions for deid to perform",
+        title="commands",
         dest="command",
+        help="command for deid to perform",
+        description="command for deid to perform",
     )
 
     subparsers.add_parser(
         "version", help="print version and exit"  # pylint: disable=unused-variable
     )
 
-    # Checks (checks / tests for various services)
     inspect = subparsers.add_parser(
-        "inspect", help="various checks for PHI and quality"
+        "inspect", help="Various checks for PHI and quality"
     )
 
+    ids = subparsers.add_parser(
+        "identifiers", help="Extract and replace identifiers from headers"
+    )
+
+    pixels = subparsers.add_parser(
+        "clean-pixels", help="Clean dicom: scrub burn in pixels"
+    )
+
+    # '--deid' for each command rather than once in global to keep arg order
+    # currently --deid is expected after args.command, like:
+    #   deid identifiers --deid deid.cfg
+    # would be breaking change to put '--deid' in main 'parser' var, like:
+    #   deid --died deid.cfg identifiers
+    # not doing so (any existing scripts) would give error. see tests/test_cli.py
+    # > deid: error: unrecognized arguments: --deid deid.cfg
+    for command in [ids, inspect, pixels]:
+        command.add_argument(
+            "--deid",
+            dest="deid",
+            help="deid file with preferences, if not specified, default used.",
+            type=str,
+            default=None,
+        )
+
+    # '--input' is shared, but not for 'inspect'
+    # instead all additional arguments to 'inspect' are inputs
+    for command in [ids, pixels]:
+        command.add_argument(
+            "--input",
+            dest="input",
+            help="Input folder or single image to perform action on.",
+            type=str,
+            default=None,
+        )
+
+    ## Args for command='inspect' only
     inspect.add_argument(
         nargs="+",
         dest="folder",
@@ -94,14 +130,6 @@ def get_parser():
         default=None,
     )
 
-    inspect.add_argument(
-        "--deid",
-        dest="deid",
-        help="deid file with preferences, if not specified, default used.",
-        type=str,
-        default=None,
-    )
-
     inspect.add_argument(
         "--pattern",
         dest="pattern",
@@ -119,18 +147,7 @@ def get_parser():
         action="store_true",
     )
 
-    ids = subparsers.add_parser(
-        "identifiers", help="extract and replace identifiers from headers"
-    )
-
-    ids.add_argument(
-        "--deid",
-        dest="deid",
-        help="deid file with preferences, if not specified, default used.",
-        type=str,
-        default=None,
-    )
-
+    ## Args for command='identifiers' only
     # A path to an ids file, required if user wants to put (without get)
     ids.add_argument(
         "--ids",
@@ -140,14 +157,6 @@ def get_parser():
         default=None,
     )
 
-    ids.add_argument(
-        "--input",
-        dest="input",
-        help="Input folder or single image to perform action on.",
-        type=str,
-        default=None,
-    )
-
     # Action
     ids.add_argument(
         "--action",
@@ -159,6 +168,15 @@ def get_parser():
         required=True,
     )
 
+    ## Args for command='clean-pixels' only
+    pixels.add_argument(
+        "--type",
+        dest="type",
+        help="Input type. Currently only dicom supported.",
+        choices=["dicom"],
+        default="dicom",
+    )
+
     return parser
 
 
@@ -181,10 +199,14 @@ def main():
     # Initialize the message bot, with level above
     from deid.logger import bot  # pylint: disable=unused-import
 
+    # 'main' function use with __main__ imported from submodules based on 'command'
     if args.command == "identifiers":
         from .identifiers import main
     elif args.command == "inspect":
         from .inspect import main
+    elif args.command == "clean-pixels":
+        from .pixels import main
+
     else:
         parser.print_help()
         sys.exit(1)
diff --git a/deid/main/pixels.py b/deid/main/pixels.py
new file mode 100644
index 0000000..b65669d
--- /dev/null
+++ b/deid/main/pixels.py
@@ -0,0 +1,47 @@
+#!/usr/bin/env python3
+"""
+CLI 'main' entrypoint for pixel scrubbing
+"""
+import argparse  # for typing only
+import tempfile
+
+from deid.dicom import get_files
+from deid.dicom.pixels import DicomCleaner
+from deid.logger import bot
+
+
+def main(args: argparse.Namespace, parser: argparse.ArgumentParser = None):
+    """
+    CLI interface for pixel cleaning.
+    Used as `main` by py:func:`deid.main.main`
+
+    Also see `getting-started/dicom-pixels`
+
+    Parameters
+    ==========
+    args:  Likely created by py:func:`deid.main.get_parser`.
+           Uses output_folder, deid
+
+    parser: for compatibility with other *.main functions. Ignored.
+    """
+
+    output_folder = args.outfolder
+    if output_folder is None:
+        output_folder = tempfile.mkdtemp()
+
+    if args.input is None:
+        bot.exit("No input folder specified. Specify inputs as additional arguments.")
+    dicom_files = list(get_files(args.input))
+
+    bot.info("Looking at %i input dicoms" % len(dicom_files))
+
+    # NOTE: self.results and self.file is updated each call to detect
+    #       may want new client for each file to be safe?
+    client = DicomCleaner(output_folder=output_folder, deid=args.deid)
+    for dcm in dicom_files:
+        #: py:func:`deid.dicom.pixels.detect._has_burned_pixels_single` dictionary, not used so not saved
+        client.detect(dcm)
+        client.clean()
+        # prefix and extension empty to reuse same name as input
+        # folder=None means use self.output_folder
+        client.save_dicom(output_folder=None, prefix="", extension="")
diff --git a/deid/tests/test_clean.py b/deid/tests/test_clean.py
index 7f4dd22..42ce8e2 100644
--- a/deid/tests/test_clean.py
+++ b/deid/tests/test_clean.py
@@ -229,6 +229,50 @@ def test_pixel_cleaner_keepcoordinates_from(self):
         compare = inputpixels[0:2000, 0:2000] == outputpixels[0:2000, 0:2000]
         self.assertTrue(compare.all())
 
+    def test_get_clean_name(self):
+        from deid.dicom import DicomCleaner
+
+        # 'out/' given to cleaner not necessarily what _get_clean_name will use
+        client = DicomCleaner(output_folder="out")
+
+        # exercise normal usage
+        client.dicom_file = "XYZ.dcm"
+        new_name = client._get_clean_name(output_folder="abc", extension="png")
+        self.assertEqual(new_name, os.path.join("abc", "clean-XYZ.png"))
+
+        client.dicom_file = "XYZ.dicom"
+        new_name = client._get_clean_name(output_folder="abc", extension="png")
+        self.assertEqual(new_name, os.path.join("abc", "clean-XYZ.png"))
+
+        # !! careful with extension! was .dicom will now be .dcm
+        client.dicom_file = "XYZ.dicom"
+        new_name = client._get_clean_name(
+            output_folder="abc"
+        )  # defaults:  extension="dcm", prefix="clean-"
+        self.assertEqual(new_name, os.path.join("abc", "clean-XYZ.dcm"))
+
+        # note IMA not removed -- Siemens dicom extension not implicitly handled
+        client.dicom_file = "XYZ.IMA"
+        new_name = client._get_clean_name(output_folder="abc", extension="png")
+        self.assertEqual(new_name, os.path.join("abc", "clean-XYZ.IMA.png"))
+
+        # fully specified options to avoid any change to basename
+        client.dicom_file = "image.IMA"
+        new_name = client._get_clean_name(output_folder=None, extension="", prefix="")
+        expected_name = os.path.join("out", "image.IMA")
+        self.assertEqual(new_name, expected_name)
+
+        # prefix but no extension
+        # example: UPitt MRRC no dcm extension (via DCMTK's storescp?)
+        client.dicom_file = "MR.1.3.12.2.1107.5.2.0.18914.2025082910014953724207010"
+        new_name = client._get_clean_name(
+            output_folder=None, extension="", prefix="clean-"
+        )
+        expected_name = os.path.join(
+            "out", "clean-MR.1.3.12.2.1107.5.2.0.18914.2025082910014953724207010"
+        )
+        self.assertEqual(new_name, expected_name)
+
 
 if __name__ == "__main__":
     unittest.main()
diff --git a/deid/tests/test_cli.py b/deid/tests/test_cli.py
index 1cf1986..a9ff964 100644
--- a/deid/tests/test_cli.py
+++ b/deid/tests/test_cli.py
@@ -6,6 +6,8 @@
 import unittest
 from unittest.mock import patch
 
+import numpy as np
+
 import deid.main
 from deid.data import get_dataset
 from deid.dicom import get_files, utils
@@ -49,6 +51,47 @@ def test_deidmain_write_identifiers(self):
         # Confirm new file was srubbed
         self.assertEqual(None, outfile.get("StudyTime"))
 
+    @patch(
+        "sys.argv",
+        "deid --outfolder out/ clean-pixels --deid deid.cfg --input ./".split(" "),
+    )
+    def test_deidmain_clean_pixels(self):
+        """
+        Run example command line call to clean pixels
+        """
+        os.chdir(self.tmpdir)
+        shutil.copyfile(self.example, self.tmpdir + "/example.dicom")
+        # Confirm input data has value that will be scrubbed.
+        indcm = utils.dcmread(self.tmpdir + "/example.dicom")
+        self.assertEqual(indcm.pixel_array.shape, (456, 510, 3))
+        # index is y,x,z for censor box coordinates from deid.cfg below
+        censor_area = indcm.pixel_array[0:250, 0:100, :]
+        # all voxels in region to be scrubbed are valued. lucky us
+        self.assertEqual(np.count_nonzero(censor_area != 0), 75000)
+
+        with open(self.tmpdir + "/deid.cfg", "w") as f:
+            f.write(
+                """FORMAT dicom
+
+%filter greylist
+
+LABEL Censor Top Left
+contains SOPInstanceUID .
+  coordinates 0,0,100,250
+"""
+            )
+
+        os.makedirs("out/")
+        deid.main.main()
+
+        outfile = utils.dcmread("out/example.dicom")
+
+        # Confirm we changed pixel data
+        self.assertTrue(np.any(indcm.pixel_array != outfile.pixel_array))
+        # Confirm censor area is all zeros
+        zero_cnt = np.count_nonzero(outfile.pixel_array[0:250, 0:100, :] == 0)
+        self.assertEqual(zero_cnt, 100 * 250 * 3)  # 75000
+
 
 if __name__ == "__main__":
     unittest.main()
diff --git a/deid/version.py b/deid/version.py
index 7825e56..51746ed 100644
--- a/deid/version.py
+++ b/deid/version.py
@@ -2,7 +2,7 @@
 __copyright__ = "Copyright 2016-2025, Vanessa Sochat"
 __license__ = "MIT"
 
-__version__ = "0.4.6"
+__version__ = "0.5.0"
 AUTHOR = "Vanessa Sochat"
 AUTHOR_EMAIL = "vsoch@users.noreply.github.com"
 NAME = "deid"