Aiming at the problems in the prior art that when searching image data in a PACS system having a plurality of data, especially searching simultaneously in a plurality of image workstation, workload of a database server is sharply raised, system speed is declined, and the overall cost is added, the invention provides a caching technology based medical image database searching method, which comprises: after receiving an initial searching request, searching firstly in a local caching list; sending final searching request to the database server if not searching it, transmitting it to a local image workstation if the database server searches it, reporting the searching result to the local image workstation if not searching it in the database server. By using the method, the image data searching speed is quickened, the workload of the database server is lightened, and the working efficiency of the PACS system is improved. The invention also provides a a caching technology based medical image database searching system, which is used for guaranteeing implementation and application of the method in actual system.