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Digital watermarking is a research hotspot in the field of image security, which is protected digital image copyright. In order to ensure medical image information security, a novel medical image digital watermarking algorithm in three-dimensional Fourier compressed domain is proposed. The novel medical image digital watermarking algorithm takes advantage of three-dimensional Fourier compressed domain characteristics, Legendre chaotic neural network encryption features and robust characteristics of differences hashing, which is a robust zero-watermarking algorithm. On one hand, the original watermarking image is encrypted in order to enhance security. It makes use of Legendre chaotic neural network implementation. On the other hand, the construction of zero-watermarking adopts differences hashing in three-dimensional Fourier compressed domain. The novel watermarking algorithm does not need to select a region of interest, can solve the problem of medical image content affected. The specific implementation of the algorithm and the experimental results are given in the paper. The simulation results testify that the novel algorithm possesses a desirable robustness to common attack and geometric attack.