Anatomical landmark localization in 2D/3D images is a critical task in medical imaging. Although many general-purpose tools exist for landmark localization in classical computer vision tasks, such as pose estimation, they lack the specialized features and modularity necessary for anatomical landmark localization applications in the medical domain. Therefore, we introduce landmarker, a Python package built on PyTorch. The package provides a comprehensive, flexible toolkit for developing and evaluating landmark localization algorithms, supporting a range of methodologies, including static and adaptive heatmap regression. landmarker enhances the accuracy of landmark identification, streamlines research and development processes, and supports various image formats and preprocessing pipelines. Its modular design allows users to customize and extend the toolkit for specific datasets and applications, accelerating innovation in medical imaging. landmarker addresses a critical need for precision and customization in landmark localization tasks not adequately met by existing general-purpose pose estimation tools.