The invention discloses a medical image interpretation method based on intelligent speech recognition. The method comprises the steps that a medical image file to be interpreted is received; interpretation signals input in a speech mode are collected and recognized, and interpretation results corresponding to the interpretation signals are matched in a preset speech recognition bank, wherein the interpretation signals are speech signals input when the medical image file to be interpreted is interpreted; an image interpretation report is generated; the image interpretation report is displayed. The invention further discloses a medical image interpretation device based on intelligent speech recognition. According to the method and device, a medical image expert does not need to perform manual input to generate the image interpretation report; by adopting the speech recognition mode, the operation of medical image interpretation is simplified, and the efficiency and accuracy of medical image interpretation are improved.