Effective management and exploitation of multimedia documents requires extraction of the underlying semantics. In this paper we propose a methodology for semantic indexing and retrieval of images, based on techniques of image segmentation and classification combined with fuzzy reasoning. In the proposed knowledge-assisted analysis architecture a segmentation algorithm firstly generates a set of over-segmented regions. After that a region classification process is employed to assign semantic labels using a confidence degree and simultaneously merge regions based on their semantic similarity. This information comprises the assertional component of a fuzzy knowledge base which is used for the refinement of mistakenly classified regions and also for the extraction of rich implicit knowledge used for global image classification. This semantic metadata of images is stored in a knowledge repository by the fuzzy reasoning engine, also permitting image retrieval and ranking.