In the domain of medical imaging, maintaining the accuracy and safety of data is crucial. The paper initiates a novel medical image watermarking scheme to secure elevated imperceptibility and flexibility against various attacks. The technique combines the Local Binary Pattern (LBP) and Integer Wavelet Transform (IWT) to enhance authentication and protect patients’ privacy. The image is primarily decomposed using Integer Wavelet Transform (IWT), resulting in four subbands: (LL), (LH), (HL), and (HH), containing most of the image’s information, and is chosen to embed a watermark information. Before embedding, the watermark information is encrypted using LBP and a shared secret key \(\kappa \) and stored into ( \(\gamma \) ). The encrypted PG and LG are embedded within the HH subband to improve the watermarking process’s robustness and security. The inverse process is applied for watermark extraction: the watermark bits are extracted from the LL subband, and the metadata is retrieved from the LH subband. The HL is extracted from the HL subband, and the \(\gamma \) is extracted from the HH subband, enabling verification of the image’s authenticity and integrity. Furthermore, a comparative analysis with previous watermarking techniques is conducted, demonstrating the superiority of the proposed method. Additionally, the temper of each band is detected to identify any potential alterations or tampering, ensuring the reliability of the watermarking process.