Abstract: Optical flow is a valuable tool for motion analysis in medical imaging sequences. A reliable application requires determining the accuracy of the computed optical flow. This is a main challenge given the absence of ground truth in medical sequences. This paper presents an error analysis of Lucas-Kanade schemes in terms of intrinsic design errors and numerical stability of the algorithm. Our analysis provides a confidence measure that is naturally correlated to the accuracy of the flow field. Our experiments show the higher predictive value of our confidence measure compared to existing measures.