According to one embodiment, an image processing apparatus includes a storage unit, a specifying unit, an extraction unit and a setting processing unit. The storage unit stores first X-ray image data in which a blood vessel of an object is not visually enhanced, and second X-ray image data in which the blood vessel is visually enhanced. The specifying unit specifies a catheter image included in the first fluoroscopic image by performing image processing of the first X-ray image data. The extraction unit extracts a blood vessel region included in the second fluoroscopic image by performing image processing of the second X-ray image data. The setting processing unit sets a region of interest based on the position of end point of the catheter.