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Processing of medical images such as MRI or CT presents unique challenges compared to RGB images typically used in computer vision. These include a lack of labels for large datasets, high computational costs, and metadata to describe the physical properties of voxels. Data augmentation is used to artificially increase the size of the training datasets. Training with image patches decreases the need for computational power. Spatial metadata needs to be carefully taken into account in order to ensure a correct alignment of volumes. We present TorchIO, an open-source Python library to enable efficient loading, preprocessing, augmentation and patch-based sampling of medical images for deep learning. TorchIO follows the style of PyTorch and integrates standard medical image processing libraries to efficiently process images during training of neural networks. TorchIO transforms can be composed, reproduced, traced and extended. We provide multiple generic preprocessing and augmentation operations as well as simulation of MRI-specific artifacts. Source code, comprehensive tutorials and extensive documentation for TorchIO can be found at https://torchio.rtfd.io/. The package can be installed from the Python Package Index running 'pip install torchio'. It includes a command-line interface which allows users to apply transforms to image files without using Python. Additionally, we provide a graphical interface within a TorchIO extension in 3D Slicer to visualize the effects of transforms. TorchIO was developed to help researchers standardize medical image processing pipelines and allow them to focus on the deep learning experiments. It encourages open science, as it supports reproducibility and is version controlled so that the software can be cited precisely. Due to its modularity, the library is compatible with other frameworks for deep learning with medical images.