We present several case studies which examine the role that the Insight Toolkit (ITK) played in three medical image analysis courses and several conference tutorials. These courses represent the first use of ITK in a teaching environment, and we believe that a discussion of the teaching approach in each case and the benefits and challenges of ITK will be useful to future medical image analysis course development. ITK was found to provide significant value in a classroom setting since it provides both working “canned” algorithms, including some recently developed methods that are unavailable elsewhere, as well as a framework for developing new techniques and applications. Several areas of difficulty, particularly in regards to code complexity and advanced object-oriented design techniques, have been identified which may make the learning curve of ITK somewhat more complex than a language such as Matlab™.