For B-mode ultrasound images, we propose an image enhancement algorithm based on a multi-resolution approach, which consists of edge enhancing and noise reducing procedures. Edge enhancement processing is applied sequentially to coarse-to-fine resolution images obtained from wavelet-transformed data. In each resolution, the structural features of each pixel are examined through eigen analysis. Then, if a pixel belongs to an edge region, we perform two-step filtering: that is, directional smoothing is conducted along the tangential direction of the edge to improve continuity and directional sharpening is conducted along the normal direction to enhance the contrast. In addition, speckle noise is alleviated by proper attenuation of the wavelet coefficients of the homogeneous regions at each band. This region-based speckle-reduction scheme is differentiated from other methods that are based on the magnitude statistics of the wavelet coefficients. The proposed algorithm enhances edges regardless of changes in the resolution of an image, and the algorithm efficiently reduces speckle noise without affecting the sharpness of the edge. Hence, compared with existing algorithms, the proposed algorithm considerably improves the subjective image quality without providing any noticeable artifacts.