Based on the integration of the advanced visualization toolkit (VTK) and the real-time rendering System (VolumePro), 4D View, a 3D real-time visualization system of medical image, which applies real-time 3D medical image (such as MR, CT image, etc.) visualization and interaction was developed. Firstly the VTK, VolumePro and their integration were introduced briefly; then the system design and function template of 4D View system was discussed in detail; finally some visualization results acquired through 4D View was illustrated. According to the results, 4D View system can effectively resolve the poor real-time characteristic of 3D medical image visualization and interaction, so it will have a wide application area of the clinical diagnosis, therapy and medical research, etc in future.