Mammographic technology has improved dramatically in the last two decades. The advent of digitally acquired mammograms offers the possibility of further improvements in early breast cancer detection. Specifically, digital acquisition systems decouple the process of X-ray photon detection from image display by using a primary detector that directly quantifies transmitted photons. Digital systems also allow a wide dynamic range so that a wider range of tissue contrast can be appreciated. Digital systems have the capacity to bring revolutionary advantages to breast cancer detection and management (1) image processing for increased lesion conspicuity; (2) computer-aided diagnosis for enhanced radiologic interpretation; (3) teleradiology, or image transmission, as a means of bringing world-class expertise to community hospitals and remote areas; (4) improved image access and communication through digital image archiving and transmission; and (5) dynamic, or “real time” imaging for use during biopsy and localization procedures. In this article, the authors review the literature 011 the use of image processing and computer assisted diagnosis for digital mammography. Future research goals in the development of digital mammography are also discussed.