We present ultra high speed optical coherence tomography (OCT) with multi-megahertz line rates and investigate the achievable image quality. The presented system is a swept source OCT setup using a Fourier domain mode locked (FDML) laser. Three different FDML-based swept laser sources with sweep rates of 1, 2.6 and 5.2MHz are compared. Imaging with 4 spots in parallel quadruples the effective speed, enabling depth scan rates as high as 20.8 million lines per second. Each setup provides at least 98dB sensitivity and approximately 10microm resolution in tissue. High quality 2D and 3D imaging of biological samples is demonstrated at full scan speed. A discussion about how to best specify OCT imaging speed is included. The connection between voxel rate, line rate, frame rate and hardware performance of the OCT setup such as sample rate, analog bandwidth, coherence length, acquisition dead-time and scanner duty cycle is provided. Finally, suitable averaging protocols to further increase image quality are discussed.