A commercial mammography image-enhancement system manufactured by Damon Corporation (Needham, MA) is evaluated. Using a dedicated computer, the system implements a real-time video local adaptive image processing algorithm based on the Wallis equation. Radiographs of a mammographic QA phantom (Nuclear Associates Model 76-001-4) containing five groups of simulated breast microcalcifications ranging in diameter from 0.12 to 0.35 mm were viewed by four investigators under three viewing conditions: on a light box with the unaided eye, on the image enhancer in magnified “bypass” (unenhanced) mode, and on the enhancer using all features for optimum enhancement. A mammogram was then overlaid on the radiographs, and the composite images were viewed under the same three conditions. Using the enhancer, as compared to using a light box alone, average increases of 1.4 and 1.1 microcalcifications per radiograph were observed for the phantom and phantom-with-mammogram radiographs, respectively. High-contrast resolution and spatial distortion were also measured.