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Laser speckle imaging (LSI) is a technique in which coherent light incident on a surface produces a reflected speckle pattern that is related to the underlying movement of optical scatterers, such as red blood cells, indicating blood flow. Image-processing algorithms can be applied to produce speckle flow index (SFI) maps of relative blood flow. We present a novel algorithm that employs the NVIDIA Compute Unified Device Architecture (CUDA) platform to perform laser speckle image processing on the graphics processing unit. Software written in C was integrated with CUDA and integrated into a LabVIEW Virtual Instrument (VI) that is interfaced with a monochrome CCD camera able to acquire high-resolution raw speckle images at nearly 10 fps. With the CUDA code integrated into the LabVIEW VI, the processing and display of SFI images were performed also at ∼10 fps. We present three video examples depicting real-time flow imaging during a reactive hyperemia maneuver, with fluid flow through an in vitro phantom, and a demonstration of real-time LSI during laser surgery of a port wine stain birthmark.