An image rendering method and apparatus, a device, and a medium. The method includes: determining a pre-captured initial rendering video stream for a background image; obtaining initial rendering coordinates of each rendering pixel in each initial rendering image frame in the video stream, and obtaining a rendering moment of each initial rendering image frame in the initial rendering video stream; determining the amount of noise of each rendering pixel at the corresponding rendering moment according to the corresponding initial rendering coordinates, a preset noise texture, and the corresponding rendering moment, and obtaining target rendering coordinates of each rendering pixel according to the corresponding amount of noise; and updating the initial rendering coordinates of each rendering pixel according to the corresponding target rendering coordinates to obtain a target rendering image, and rendering the background image according to a target rendering video stream composed of all target rendering images.