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This paper describes a novel medical three-dimensional (3-D) autostereoscopic image for surgical navigation. The 3-D image created by an animated visualization of integral videography (IV), which spatially reproduces a computer generated graphical object by multiple rays through a micro convex lens array. IV can display geometrically accurate autostereoscopic images and reproduce motion parallax. This technique requires neither special glasses nor sensing device to track viewer's eyes, thus being suitable for pre-operative diagnosis and intra-operative in image-guided surgery. We summarize the development and evaluation of the IV image for the surgical navigation system in this paper. Relative landmarks-based and marker-less patient-image registration method are developed for IV image overlay navigation system. We evaluate the feasibility of the IV image by a set of phantom and volunteer experiments. Experiments demonstrated that the IV image surgical navigation system is possible to increase the accuracy of the surgical implementation and to reduce the procedure time as the result of intuitive 3D viewing.