Visual images in textbooks can stimulate students’ interest and encourage them to learn language in more critical and creative ways (Canning 1997; Curtis and Bailey 2001). The existence of visual images in medical textbooks has brought many benefits to the ESP classroom. However, there is a lack of research on multimodality in medical textbooks that focuses on the textbook's verbal and visual elements. Therefore, the study attempts to explore the aspects of verbal and visual elements in medical textbooks and analyze the visual element's role in understanding the verbal component. The data of multimodal elements found is taken from two medical textbooks. The qualitative analysis of the yielded results was couched with Kress and Van Leeuwen’s (2006) Visual Grammar framework to identify the ideational functions of the verbal elements and three patterns of visual elements in medical textbooks. The findings give pedagogical benefits to medical students in understanding the text and show that there should be an improvement in visual elements' color and size. Keywords: Ideational function, multimodality, visual images, visual grammar design, medical textbooks.