With the help of big data, cloud computing, artificial intelligence and other technologies, the informatization and intelligence of the wisdom medical have been gradually realized. However, with the transmission and storage of massive amounts of medical images in the cloud, information security issues have become increasingly prominent. The privacy of patients is at risk of disclosure, theft and tampering, which has become an important challenge restricting the development of wisdom medical. How to protect the personal information of patients in the cloud environment has become an urgent problem to be solved. Medical image watermarking technology is an effective method to solve this problem. Combining the characteristics of Tent chaos and Henon chaos, this paper designed a Tent-Henon-Map double chaos watermarking encryption method and designed a medical image encryption watermarking algorithm based on ridgelet-DCT transform. The watermark images were encrypted by the Tent-Henon-Map double chaos which had the characteristics of sensitive initial values and large key space. Then, the feature vectors of the medical images were extracted through ridgelet-DCT transform. On the basis of ordinary watermarking technology, combined with zero watermarking, third-party concepts, and cryptographic technology, watermarking had a good ability to resist image processing attacks. The experimental results showed that the key space of the algorithm was $${10}^{116}$$
10
116
, which had better encryption and hard to crack. The time of watermark embedding and extraction were only 0.336 s and 0.439 s, with lower computational cost. And under high-strength conventional attacks and geometric attacks, the NC values of the algorithm were all greater than 0.55, which could effectively extract watermark information. It shown that the algorithm proposed had good robustness against conventional and geometric attacks It shown that the algorithm proposed had good robustness against conventional and geometric attacks, while taking into account the security.