GIMIAS is a workflow-oriented environment focused on biomedical image computing and simulation. The open-source framework is extensible through plug-ins and is focused on building research and clinical software prototypes. Gimias has been used to develop clinical prototypes in the fields of cardiac imaging and simulation, angiography imaging and simulation, and neurology GIMIAS is being funded by several national and international projects like cvREMOD, euHeart or VPH NoE. About GIMIAS GIMIAS stands for Graphical Interface for Medical Image Analysis and Simulation. GIMIAS provides a graphical user interface with all main data IO, visualization and interaction functions for images, meshes and signals. GIMIAS features include: DICOM browser and PACS connection Support for different imaging modalities Biomedical data visualization in 2D and 3D: multiplanar reformation, ortho slice view, multi slice view, volume rendering, X-ray rendering, maximum intensity projection Several input and output formats: DICOM, vtk, stl, Nifty, Analyze. Movie control: play, pause, speed control Multiple data objects: 2D DICOM images, 3D images, surface meshes, volumetric meshes, signals or annotations Image and surface mesh annotations: landmarks, measurements and regions of interest Clinical workflow navigation that can help the user to navigate from patient data to useful information for patient treatment. Other additional tools for image segmentation, mesh manipulation and signal navigation. GIMIAS is a development framework that allows developers to create their own medical applications using different plug-ins that can be dynamically loaded and combined. The prototypes developed on GIMIAS can be verified by end users in real scenarios and with real data at early development stages. Is developed using C++ language, has a plug-in architecture, and is cross-platform by means of the standard CMake tool. Is possible to integrate new libraries using CSnake tool and is based on common open source libraries like VTK, ITK, MITK, BOOST and wxWidgets. A plug-in can extend the framework adding new processing components, GUI components like toolbars or windows, new data processing types or new rendering libraries. GIMIAS supports several types of plug-ins, starting from a simple DLL, a 3D Slicer compatible command line plug-in or a more complex GIMIAS plug-in with customized graphical interface. Automated GUI generation and extensible data object model allow to share plug-ins with other frameworks and empower interoperability. The software is available on Windows and Linux, 64-bit and 32-bit. History Initial versions of the open source framework was released by the end of 2009 (GIMIAS 0.6.15 was released in October 2009). In