This book constitutes the refereed proceedings of the 19th Scandinavian Conference on Image Analysis, SCIA 2015, held in Copenhagen, Denmark, in June 2015. The 45 revised papers presented were carefully reviewed and selected from 67 submissions. The contributions are structured in topical sections on novel applications of vision systems, pattern recognition, machine learning, feature extraction, segmentation, 3D vision to medical and biomedical image analysis.