The medical image is an image that needs to be protected because it is private and confidential. The more modern technology enables tele surgery, tele diagnosis, and others to demand safe and confidential medical images. This research proposes cryptography method in a medical image by using the combination algorithm of Arnold chaotic map (ACM) and Rivest Cipher 4 (RC4). ACM is a chaotic cryptographic technique superior to attack deferential attack and brute force. The way chaotic cryptography works is to confuse the pixel location. While RC4 is a stream cipher technique that has resistance to statistical attacks and fasts in computing. The purpose of merging these two algorithms is to get stronger encryption techniques, have good performance, and can be computed quickly. Based on the experimental results proved that the use of a combination of these two algorithms can produce satisfactory quality encryption. This is evidenced by several measuring tools such as SSIM, Correlation Coefficient, Entropy, NPCR, UACI, and histogram analysis. Computation time required is also relatively very fast ie less than one second, where computational time is calculated by tic toc function.