This book constitutes the refereed proceedings of the first MICCAI Workshop, ISGIE 2022, Imaging Systems for GI Endoscopy, and the Fourth MICCAI Workshop, GRAIL 2022, GRaphs in biomedicAL Image and analysis, held in conjunction with MICCAI 2022, Singapore, September 18, 2022. ISGIE 2022 accepted 6 papers from the 8 submissions received.This workshop focuses on novel scientific contributions to vision systems, imaging algorithms as well as the autonomous system for endorobot for GI endoscopy. This includes lesion and lumen detection, as well as 3D reconstruction of the GI tract and hand-eye coordination. GRAIL 2022 accepted 6 papers from the 10 submissions received. The workshop aims to bring together scientists that use and develop graph-based models for the analysis of biomedical images and to encourage the exploration of graph-based models for difficult clinical problems within a variety of biomedical imaging contexts.