With the continuous progress and development in the field of Internet technology, the area of medical image processing has also developed along with it. Specially, digital watermarking technology plays an essential role in the field of medical image processing and greatly improves the security of medical image information. A medical image watermarking algorithm based on an accelerated‐KAZE discrete cosine transform (AKAZE‐DCT) is proposed to address the poor robustness of medical image watermarking algorithms to geometric attacks, which leads to low security of the information contained in medical images. First, the AKAZE‐DCT algorithm is used to extract the feature vector of the medical image and then combined with the perceptual hashing technique to obtain the feature sequence of the medical image; then, the watermarking image is encrypted with logistic chaos dislocation to get the encrypted watermarking image, which ensures the security of the watermarking information; finally, the watermarking is embedded and extracted with the zero‐watermarking technique. The experimental results show that the algorithm can effectively extract the watermark under conventional and geometric attacks, reflecting better robustness and invisibility, and has certain practicality in the medical field compared with other algorithms.