Disclosure includes system, method and architecture for selecting supplemental digital content using visual appearance. Digital content that is visually similar, or dissimilar, to digital content requested by a user can he identified and provided for presentation with the requested content. The additional digital content is visually congruent, or visually incongruent, with content requested by a user, such that the additional content is similar, or dissimilar, to the requested content from a visual standpoint. In a presentation of the requested content, the presentation position of each additional content item relative to the presentation position of each requested content can be identified using visual congruence, or visual incongruence.