This chapter discusses semantic image analysis for the purpose of automatic image understanding and efficient visual content access and retrieval at semantic level. It presents the current state of the art analysis approaches aiming at bridging the “semantic gap” in image analysis and retrieval, highlights the major achievements of the existing approaches and sheds light to the challenges still unsolved. Its main subject is to present a generic framework for performing knowledge-assisted semantic analysis of images and also to present the Knowledge-Assisted Analysis as performed in the aceMedia