diff --git a/recommonmark/parser.py b/recommonmark/parser.py
index 857aded..0046ea6 100644
--- a/recommonmark/parser.py
+++ b/recommonmark/parser.py
@@ -178,8 +178,15 @@ class CommonMarkParser(parsers.Parser):
         img_node = nodes.image()
         img_node['uri'] = mdnode.destination
 
-        if mdnode.title:
-            img_node['alt'] = mdnode.title
+        if mdnode.first_child and mdnode.first_child.literal:
+            content = [mdnode.first_child.literal]
+            n = mdnode.first_child
+            mdnode.first_child.literal = ''
+            mdnode.first_child = mdnode.last_child = None
+            while getattr(n, 'nxt'):
+                n.nxt, n = None, n.nxt
+                content.append(n.literal)
+            img_node['alt'] = ''.join(content)
 
         self.current_node.append(img_node)
         self.current_node = img_node
diff --git a/tests/sphinx_generic/index.md b/tests/sphinx_generic/index.md
index 64f21f9..d699b79 100644
--- a/tests/sphinx_generic/index.md
+++ b/tests/sphinx_generic/index.md
@@ -23,7 +23,7 @@ Foo
 
 Bar
 
-![foo](/image.png "Example")
+![foo "handle quotes"](/image.png "Example")
 
     #!/bin/sh
     python
diff --git a/tests/test_basic.py b/tests/test_basic.py
index 545c097..798c395 100644
--- a/tests/test_basic.py
+++ b/tests/test_basic.py
@@ -226,13 +226,13 @@ class TestParsing(unittest.TestCase):
     def test_image(self):
         self.assertParses(
             """
-            ![foo](/url "title")
+            ![foo "handle quotes"](/url "title")
             """,
             """
             <?xml version="1.0" ?>
             <document source="&lt;string&gt;">
               <paragraph>
-                <image alt="title" uri="/url">foo</image>
+                <image alt="foo &quot;handle quotes&quot;" uri="/url"></image>
               </paragraph>
             </document>
             """
diff --git a/tests/test_sphinx.py b/tests/test_sphinx.py
index 00e2e03..06078b1 100644
--- a/tests/test_sphinx.py
+++ b/tests/test_sphinx.py
@@ -129,7 +129,7 @@ class GenericTests(SphinxIntegrationTests):
     def test_image(self):
         output = self.read_file('index.html')
         self.assertIn(
-            '<p><img alt="Example" src="image.png" />foo</p>',
+            '<p><img alt="foo &quot;handle quotes&quot;" src="image.png" /></p>',
             output
         )