The UWGSP5, also known as MediaStation 5000, is the latest entry in a series of high- performance medical imaging workstations developed at the University of Washington Image Computing Systems Laboratory. In addition to its image processing and graphics performance, the UWGSP5 has multimedia capabilities that set it apart from traditional medical workstations. It supports continuous streams of video and audio data for real-time acquisition and playback, and implements real-time compression and decompression algorithms including the MPEG, JPEG, and P X 64 standards. Also, other compression algorithms optimized for medical images can be easily implemented on the UWGSP5. The fast decompression capability also allows for rapid reconstruction and display of stored compressed images, making the UWGSP5 suitable for a medical consultation workstation as well as a specialty image processing and graphics workstation. In this paper, we present the hardware architecture and software organization of the UWGSP5 and its performance on various image display, processing, and compression algorithms.