We derive general formulas for photon and dilepton production rates from an arbitrary non-equilibrated medium from first principles in quantum field theory. At lowest order in the electromagnetic coupling constant, these relate the rates to the unequal-time in-medium photon polarization tensor and generalize the corresponding expressions for a system in thermodynamic equilibrium. We formulate the question of electromagnetic radiation in real time as an initial value problem and consistently describe the virtual electromagnetic dressing of the initial state. In the limit of slowly evolving systems, we recover known expressions for the emission rates and work out the first correction to the static formulas in a systematic gradient expansion. Finally, we discuss the possible application of recently developed techniques in non-equilibrium quantum field theory to the problem of electromagnetic radiation. We argue, in particular, that the two-particle-irreducible (2PI) effective action formalism provides a powerful resummation scheme for the description of multiple scattering effects, such as the Landau-Pomeranchuk-Migdal suppression recently discussed in the context of equilibrium QCD.