This book constitutes the refereed proceedings of the 5th Workshop on Uncertainty for Safe Utilization of Machine Learning in Medical Imaging, UNSURE 2023, held in conjunction with MICCAI 2023 in Vancouver, Canada, in October 2023. For this workshop, 21 papers from 32 submissions were accepted for publication. The accepted papers cover the fields of uncertainty estimation and modeling, as well as out of distribution management, domain shift robustness, Bayesian deep learning and uncertainty calibration.