Content-based image retrieval (CBIR) makes use of image features, such as color and texture, to index images with minimal human intervention. Content-based image retrieval can be used to locate medical images in large databases. This chapter introduces a content-based approach to medical image retrieval. Fundamentals of the key components of content-based image retrieval systems are introduced first to give an overview of this area. A case study, which describes the methodology of a CBIR system for retrieving digital mammogram database, is then presented. This chapter is intended to disseminate the knowledge of the CBIR approach to the applications of medical image management and to attract greater interest from various research communities to rapidly advance research in this field.