The disclosure herein relates to systems, methods, and devices for medical image analysis, diagnosis, risk stratification, decision making and / or disease tracking. In some embodiments, the systems, devices, and methods described herein are configured to analyze non-invasive medical images of a subject to automatically and / or dynamically identify one or more features, such as plaque and vessels, and / or derive one or more quantified plaque parameters, such as radiodensity, radiodensity composition, volume, radiodensity heterogeneity, geometry, location, and / or the like. In some embodiments, the systems, devices, and methods described herein are further configured to generate one or more assessments of plaque-based diseases from raw medical images using one or more of the identified features and / or quantified parameters.