The two-volume set LNCS 11751 and 11752 constitutes the refereed proceedings of the 20th International Conference on Image Analysis and Processing, ICIAP 2019, held in Trento, Italy, in September 2019. The 117 papers presented were carefully reviewed and selected from 207 submissions. The papers cover both classic and the most recent trends in image processing, computer vision, and pattern recognition, addressing both theoretical and applicative aspects. They are organized in the following topical sections: Video Analysis and Understanding; Pattern Recognition and Machine Learning; Deep Learning; Multiview Geometry and 3D Computer Vision; Image Analysis, Detection and Recognition; Multimedia; Biomedical and Assistive Technology; Digital Forensics; Image processing for Cultural Heritage.