This book constitutes the thoroughly refereed proceedings of the 15th International Conference on Image Analysis and Recognition, ICIAR 2018, held in Póvoa de Varzim, Portugal, in June 2018. The 91 full papers presented together with 15 short papers were carefully reviewed and selected from 179 submissions. The papers are organized in the following topical sections: Enhancement, Restoration and Reconstruction, Image Segmentation, Detection, Classication and Recognition, Indexing and Retrieval, Computer Vision, Activity Recognition, Traffic and Surveillance, Applications, Biomedical Image Analysis, Diagnosis and Screening of Ophthalmic Diseases, and Challenge on Breast Cancer Histology Images.