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Image segmentation with monotonicity and smoothness constraints has found applications in several areas such as biomedical image analysis and data mining. In this paper, we study the problem of segmenting monotone and smooth objects in 2-D and 3-D images. For the 2-D case of the problem, we present an O(IJ log J) time algorithm, improving the previously best known O(IJ2M) time algorithm by a factor of O(JM/log J) time, where the size of the input 2-D image is I × J and M is the smoothness parameter with 1 ≤ M ≤ J. Our algorithm is based on a combination of dynamic programming and divide-and-conquer strategy, and computes an optimal path in an implicitly represented graph. We also prove that a generalized version of the 3-D case of the problem is NP-hard.