A free visual programming-based image analysis development environment for medical imaging applications called NeatVision was developed to provide high-level access to a wide range of image processing algorithms through a well-defined, easy-to-use graphical interface. The system contains over 300 image manipulation, processing, and analysis algorithms. For more advanced users, an upgrade path is provided to extend the core library with use of the developer's interface, giving users access to additional plug-in features, automatic source code generation, compilation with full error feedback, and dynamic algorithm updates. NeatVision was designed to allow users at all levels of expertise to focus on the computer vision design task for computer-aided diagnostic (CAD) applications rather than the subtleties of a particular programming language. The environment allows the designers of image analysis-based CAD techniques to implement their ideas in a dynamic and straightforward manner. Both NeatVision standard and developer's versions can be downloaded free of charge from the Internet and can run on a variety of computer platforms.