The detection of architectural distortions and abnormal structures in mammographic images can be based on the analysis of bilateral and temporal cases using image registration. This paper presents a quantitative evaluation of state-of-the art intensity based image registration methods applied to mammographic images. These methods range from a global and rigid transformation to local deformable paradigms using various metrics and multiresolution approaches. The aim of this study is to assess the suitability of these methods for mammographic image analysis. Evaluation using temporal cases based on quantitative analysis and a multiobserver study is presented which gives an indication of the accuracy and robustness of the different algorithms. Although previous studies suggested that local deformable methods were not suitable due to the generation of unrealistic distortions, in this work we show that local deformable paradigms (multiresolution B-Spline deformations) obtain the most accurate registration results.