One of the current issues for picture archiving and communication systems (PACS) is extending retrieval technologies to deal with multimedia information. This is particularly important for medical applications that assist in diagnostic processes and pathology studies. Accordingly, this paper presents a new approach to content-based image retrieval (CBIR) for a clinical ultrasound image database (DB). The proposed algorithm consists of two stages so as to maximize the retrieval efficiency. In the first stage, a coarse retrieval is performed using the statistical characteristics of the wavelet coefficients that narrow the search by eliminating up to 70% of the total DB images. In the second stage, a fine retrieval is carried out using the Legendre moment of the global histogram pdf on the reduced image set preretrieved by the coarse retrieval. When tested on an abdominal ultrasound image DB and compared with various other methods, the proposed algorithm gave promising results for applying CBIR to clinical ultrasound images.