An image processing apparatus of the present invention includes: a structure index calculation unit that calculates a structure index that is an index of magnitude of variation of a pixel value in a predetermined range around a target pixel of an input image, with respect to each target pixel; a high frequency component extraction unit that extracts a high frequency structure index that is a high frequency component of the structure index; a smoothing unit that calculates a smoothed structure index obtained by smoothing the structure index, with respect to the each target pixel; a flatness index calculation unit that calculates a synthesis index obtained by synthesizing the smoothed structure index and the high frequency structure index, as a flatness index of the target pixel; and a noise reduction unit that performs a noise reduction process of the target pixel in accordance with the flatness index.