This book constitutes the refereed proceedings of the 5th Mediterranean Conference on Pattern Recognition and Artificial Intelligence, MedPRAI 2021, held in Istanbul, Turkey, in December 2021. Due to the COVID-19 pandemic, MedPRAI 2021 was held fully online. The 28 revised full papers and 4 short papers presented were thoroughly reviewed and selected from 72 submissions. The papers are covering the topics of recent advancements in different areas of pattern recognition and artificial intelligence, such as statistical, structural and syntactic pattern recognition, machine learning, data mining, neural networks, computer vision, multimedia systems, information retrieval, etc.