Image analysis is now well established in quantifying and characterising microorganisms from fermentation samples. In filamentous fermentations it has become an invaluable tool for characterising complex mycelial morphologies, although it is not yet used extensively in industry. Recent method developments include characterisation of spore germination from the inoculum stage and of the subsequent dispersed and pellet forms. Further methods include characterising vacuolation and simple structural differentiation of mycelia, also from submerged cultures. Image analysis can provide better understanding of the development of mycelial morphology, of the physiological states of the microorganisms in the fermenter, and of their interactions with the fermentation conditions. This understanding should lead to improved design and operation of mycelial fermentations.