We propose new lossless medical image compression method based on hierarchical sorting technique. Hierarchical sorting is a technique to achieve high compression ratio by detecting the regions where image pattern varies abruptly and sorting pixel order by its value to increase predictability. In this method, we can control sorting accuracy along with size and complexity. As the result, we can reduce the sizes of the permutation-tables and reuse the tables to other image regions. Comparison using experimental implementation of this method shows better performance for medical image set measured by X-ray CT and MRI instruments where similar sub-block patterns appear frequently. This technique applies quad-tree division method to divide an image to blocks in order to support progressive decoding and fast preview of large images.