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To circumvent this problem, this research proposes a medical image enhancement (MIE) approach based on the hybrid simulated annealing\u2010evaporation rate\u2010based water cycle algorithm (SA\u2010ERWCA). The ERWCA enhances distorted medical images by finding the best optimal solution for the transformation parameters according to the fitness function. The fitness function consists of three objective measurements, namely, entropy, number of edges, and sum of edge intensities. Due to its high potential for finding a globally optimal solution, SA is applied solely to determine the optimized initial population of the ERWCA, thereby enhancing its convergence characteristics. To simply put, the main objective of SA is to avoid premature convergence of the ERWCA. Thus, blending SA and ERWCA produces better\u2010quality medical images. The performance of the proposed algorithm was compared to histogram equalization (HE), low contrast stretching (LCS), contrast\u2010limited adaptive histogram equalization (CLAHE), particle swarm optimization (PSO), accelerated PSO (APSO), and the water cycle algorithm (WCA). Along with the objective function fitness, seven full reference (FR) image quality assessment (IQA) metrics were implemented to evaluate image quality and compare performance. The findings of the present study showed that the proposed strategy outperforms all of the compared methods in terms of objective function fitness and perceptual visual IQA metrics such as the Harr wavelet\u2010based perceptual similarity index (HaarPSI), visual signal\u2010to\u2010noise ratio (VSNR), and information content weighted structural similarity index measure (IW\u2010SSIM). The suggested technique also exhibited better stability and faster convergence time to the optimum solution. 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