Due to the advances in computer-based communication and health services over the past decade, the need for image security becomes urgent to address the requirements of both safety and non-safety in medical applications. This paper proposes a new fragile watermarking-based scheme for image authentication and self-recovery for medical applications. The proposed scheme locates image tampering as well as recovers the original image. A host image is broken into 4\times 4 blocks and singular value decomposition (SVD) is applied by inserting the traces of block wise SVD into the least significant bit of the image pixels to figure out the transformation in the original image. Two authentication bits namely block authentication and self-recovery bits are used to survive the vector quantization attack. The insertion of self-recovery bits is determined with Arnold transformation, which recovers the original image even after a high tampering rate. SVD-based watermarking information improves the image authentication and provides a way to detect different attacked area of the watermarked image. The proposed scheme is tested against different types of attacks such as text removal attack, text insertion attack, and copy and paste attack. Compared with the state-of-the art methods, the proposed scheme greatly improves both tamper localization accuracy and the peak signal to noise ratio of self-recovered image. © 2013 IEEE.