With the present amounts of produced educational data, there is a high demand in techniques and methods capable of handling multimedia contents adequately. Educational content has to be presented, deployed, stored, navigated, searched, retrieved, edited, combined, and reused in a proper way. Furthermore, quality control and learning processes with feedback loops are considered to be important concepts for more effective and sustainable e-learning solutions. Multimedia technologies facilitate the evaluation, improvement, and assurance of quality in loopback controlled e-learning processes. The Fourth IEEE International Workshop on Multimedia Technologies for E-Learning was held in San Diego, California in December 2009 and brought experts from these respective fields together. The articles in this e-book of Interactive Technology and Smart Education are the revised and significantly extended versions of outstanding papers presented at the MTEL 2009 workshop.