In order to help medical personnel to make accurate clinical judgment, we built a DSP real-time image enhancement system to enhance and sharpening the hand vein distribution image. First, we use 760 nm and 960 nm mixed near-infrared light as the light source to decrease the skin scattering and absorption of the incident light, and gain a distinct original image. Then, we analyzed the vascular model in the multi-scale method, and using the vascular response function to take the place of gradient in diffusion equation, constructed the Forward And Backward Diffusion (FABD) coefficients. Then, we realized it in the DM642 DSP hardware platform; finally, the proposed enhancement algorithms implemented on the hardware platform, and compared with anisotropic diffusion algorithm and forward and backward diffusion algorithm. The results showed that, the proposed system to enhance the images standard deviation than the original increased by 11.4971, and increased by 2.2530 and 1.1500 than the anisotropic diffusion algorithm and forward and backward diffusion algorithm respectively. The proposed system’s processing time was 28.0ms, and met real time requirements. The system was stable, reliable and met the medical needs.