This book constitutes the refereed proceedings of the 24th Conference on Medical Image Understanding and Analysis, MIUA 2020, held in July 2020. Due to COVID-19 pandemic the conference was held virtually.  The 29 full papers and 5 short papers presented were carefully reviewed and selected from 70 submissions. They were organized according to following topical sections: ​image segmentation; image registration, reconstruction and enhancement; radiomics, predictive models, and quantitative imaging biomarkers; ocular imaging analysis; biomedical simulation and modelling.