Watermarking is a technique to embed identification codes, called watermarks, into cover media or host media and used for protection of intellectual property as well as authentication and integrity of information. This technique does not restrict access to the information while encryption has the aim of making messages unintelligible to unauthorized persons who might intercept them. A watermark is designed to permanently reside in the host data. In this literature an integer wavelet transform (IWT) based algorithm for transmission and security of medical images has been proposed. The IWT maps integers to integers and allows perfect inevitability with finite precision arithmetic. The extracted image which is obtained should have a high peak signal to noise ratio (PSNR) or else its discarded. At the receiver end the patient digest is cross verified to obtain back the watermarked medical image for further analysis. © 2013 Springer.