This paper presents an efficient lossless compression method for 4-D medical images based on the advanced video coding scheme (H.264/AVC). The proposed method efficiently reduces data redundancies in all four dimensions by recursively applying multiframe motion compensation. Performance evaluations on real 4-D medical images of varying modalities including functional magnetic resonance show an improvement in compression efficiency of up to three times that of other state-of-the-art compression methods such as 3D-JPEG2000.