The invention provides a medical image file transmission system, a medical image file transmission method and a server based on a bit torrent protocol. The system comprises a central server, a tracking server and a client. The central server is used for packaging a medical image file into at least one data packet in units of series in digital imaging and communications in medicine (DICOM), making a seed file for each data packet and storing the data packets and the seed files, releasing identifiers generated by the bit torrent protocol for the data packets to the tracking server, receiving a request sent by the client and used for downloading the seed file of a specified data packet, and sending the seed file of the specified data packet to the client through a secure sockets layer (SSL) protocol, wherein one data packet corresponds to one series. The tracking server is used for storing the identifiers of the at least one data packet, storing information of the central server capable of providing the data packets and information of the client, and receiving a request sent by the client and used for acquiring information of the central server capable of providing the specified data packet and information of other clients. The client is used for issuing a request for downloading the seed file of the specified data packet to the central server, acquiring the seed file of the specified data packet from the central server through the secure sockets layer (SSL) protocol, issuing a request for acquiring information of the central server capable of providing the specified data packet and information of other clients to the tracking server according to the acquired seed file, and downloading data from the central server capable of providing the specified data packet and/or other clients according to the information acquired from the tracking server so as to acquire the specified data packet.