Image registration is playing a more and more important role in facilitating the smart use of widely available and complementary information from multiple imaging resources. To improve the efficiency and accuracy of medical image registration, in this paper, a bi-hierarchy registration method is presented. Firstly, on the basis of steerable pyramid transform with property of transformation-invariance, the images will be decomposed into multi-scale and multi-band representation. Then, to avoid transformation error accumulation and magnification during the parameter transmission, the registration will be performed only in the lowest-resolution hierarchy and the highest-resolution hierarchy. The experiments on medical images demonstrate that the proposed registration is of high performance and is robust to noise.