Real-time display of processed Fourier domain optical coherence tomography (FDOCT) images is important for applications that require instant feedback of image information, for example, systems developed for rapid screening or image-guided surgery. However, the computational requirements for high-speed FDOCT image processing usually exceeds the capabilities of most computers and therefore display rates rarely match acquisition rates for most devices. We have designed and developed an image processing system, including hardware based upon a field programmable gated array, firmware, and software that enables real-time display of processed images at rapid line rates. The system was designed to be extremely flexible and inserted in-line between any FDOCT detector and any Camera Link frame grabber. Two versions were developed for spectrometer-based and swept source-based FDOCT systems, the latter having an additional custom high-speed digitizer on the front end but using all the capabilities and features of the former. The system was tested in humans and monkeys using an adaptive optics retinal imager, in zebrafish using a dual-beam Doppler instrument, and in human tissue using a swept source microscope. A display frame rate of 27 fps for fully processed FDOCT images (1024 axial pixels x 512 lateral A-scans) was achieved in the spectrometer-based systems.