Adaptive imaging methods and systems for generating enhanced low light video of an object for medical visualization are disclosed and include acquiring, with an image acquisition assembly, a sequence of reference frames and/or a sequence of low light video frames depicting the object, assessing relative movement between the image acquisition assembly and the object based on at least a portion of the acquired sequence of reference video frames or the acquired sequence of low light video frames, adjusting a level of image processing of the low light video frames based at least in part on the relative movement between the image acquisition assembly and the object, and generating a characteristic low light video output from a quantity of the low light video frames, wherein the quantity of the low light video frames is based on the adjusted level of image processing of the low light video frames.