We have developed and implemented a system which can acquire, process, and display the solution of the inverse scattering problem for optical coherence tomography (OCT) in real-time at frame rates of 2.25 fps for 512 × 1024 images. Frames which previously required 60 s to process, now take under 0.5 s, an improvement in processing speed by a factor of over 120 times. An efficient routine was designed which requires two interpolations of the columns, one one-dimensional real-to-complex fast Fourier transform (FFT) of the columns, and two two-dimensional FFTs. The limits to speed now rely on the parallelizability of the processing hardware. Our system provides quantitatively meaningful structural information from previously indistinguishable scattering intensities and provides proof of feasibility for future real-time systems.