Abstract. This paper describes the medical image retrieval and annotation tasks of ImageCLEF 2006. Both tasks are described with respect to goals, databases, topics, results, and techniques. The ImageCLEFmed retrieval task had 12 participating groups (100 runs). Most runs were automatic, with only a few manual or interactive. Purely textual runs were in the majority compared to purely visual runs but most were mixed, using visual and textual information. None of the manual or interactive techniques were significantly better than automatic runs. The best