Small intestinal capsule endoscopy is the mainstream method for inspecting small intestinal lesions,but a single small intestinal capsule endoscopy will produce 60,000 - 120,000 images, the majority of which are similar and have no diagnostic value. It takes 2 - 3 hours for doctors to identify lesions from these images. This is time-consuming and increase the probability of misdiagnosis and missed diagnosis since doctors are likely to experience visual fatigue while focusing on a large number of similar images for an extended period of time.In order to solve these problems, we proposed a similar wireless capsule endoscope (WCE) image screening method based on structural similarity analysis and the hierarchical clustering of visually salient sub-image blocks. The similarity clustering of images was automatically identified by hierarchical clustering based on the hue,saturation,value (HSV) spatial color characteristics of the images,and the keyframe images were extracted based on the structural similarity of the visually salient sub-image blocks, in order to accurately identify and screen out similar small intestinal capsule endoscopic images. Subsequently, the proposed method was applied to the capsule endoscope imaging workstation. After screening out similar images in the complete data gathered by the Type I OMOM Small Intestinal Capsule Endoscope from 52 cases covering 17 common types of small intestinal lesions, we obtained a lesion recall of 100% and an average similar image reduction ratio of 76%. With similar images screened out, the average play time of the OMOM image workstation was 18 minutes, which greatly reduced the time spent by doctors viewing the images.