The subject matter is lossy compression using the BPG encoder for medical images with varying levels of visual complexity, which are corrupted by Poisson noise. The goal of this study is to determine the optimal parameters for image compression and select the most suitable metric for identifying the optimal operational point. The tasks addressed include: selecting test images sized 512x512 in grayscale with varying degrees of visual complexity, encompassing visually intricate images rich in edges and textures, moderately complex images with edges and textures adjacent to homogeneous regions, and visually simple images primarily composed of homogeneous regions; establishing image quality evaluation metrics and assessing their performance across different encoder compression parameters; choosing one or multiple metrics that distinctly identify the position of the optimal operational point; and providing recommendations based on the attained results regarding the compression of medical images corrupted by Poisson noise using a BPG encoder, with the aim of maximizing the restored image’s quality resemblance to the original. The employed methods encompass image quality assessment techniques employing MSE, PSNR, MSSIM, and PSNR-HVS-M metrics, as well as software modeling in Python without using the built-in Poisson noise generator. The ensuing results indicate that optimal operational points (OOP) can be discerned for all these metrics when the compressed image quality surpasses that of the corresponding original image, accompanied by a sufficiently high compression ratio. Moreover, striking a suitable balance between the compression ratio and image quality leads to partial noise reduction without introducing notable distortions in the compressed image. This study underscores the significance of employing appropriate metrics for evaluating the quality of compressed medical images and provides insights into determining the compression parameter Q to attain the BPG encoder’s optimal operational point for specific images. Conclusions. The scientific novelty of the findings encompasses the following: 1) the capability of all metrics to determine the OOP for images of moderate visual complexity or those dominated by homogeneous areas; MSE and PSNR metrics demonstrating superior results for images rich in textures and edges; 2) the research highlights the dependency of Q in the OOP on the average image intensity, which can be reasonably established for a given image earmarked for compression based on our outcomes. The compression ratios for images compressed at the OOP are sufficiently high, further substantiating the rationale for compressing images in close proximity to the OOP.