Image registration plays a vital role in visual quality inspection of tablets with imprints. In this paper, three registration methods, based on direct matching of pixel intensities, principal axes matching and circular profile matching, were proposed and objectively evaluated on real, large and representative image database (1,634 images) of various types of non-defective and defective tablets. Comparing against a devised “gold standard” registration and considering execution times and different registration tasks, circular profile matching method proved to be a powerful image processing tool for improving visual quality inspection of imprinted tablets in real time. Keywords Image registration · Visual inspection · Imprinted tablet · Appearance model · Quality assurance