Medical large vision-language models (LVLMs) have demonstrated promising performance across various single-image question answering (QA) benchmarks, yet their capability in processing multi-image clinical scenarios remains underexplored. Unlike single image based tasks, medical tasks involving multiple images often demand sophisticated visual understanding capabilities, such as temporal reasoning and cross-modal analysis, which are poorly supported by current medical LVLMs. To bridge this critical gap, we present the Med-MIM instruction dataset, comprising 83.2K medical multi-image QA pairs that span four types of multi-image visual abilities (temporal understanding, reasoning, comparison, co-reference). Using this dataset, we fine-tune Mantis and LLaVA-Med, resulting in two specialized medical VLMs: MIM-LLaVA-Med and Med-Mantis, both optimized for multi-image analysis. Additionally, we develop the Med-MIM benchmark to comprehensively evaluate the medical multi-image understanding capabilities of LVLMs. We assess eight popular LVLMs, including our two models, on the Med-MIM benchmark. Experimental results show that both Med-Mantis and MIM-LLaVA-Med achieve superior performance on the held-in and held-out subsets of the Med-MIM benchmark, demonstrating that the Med-MIM instruction dataset effectively enhances LVLMs’ multi-image understanding capabilities in the medical domain. The Med-MIM instruction dataset, benchmark, and fine-tuned models are available at Med-MIM .