A near-infrared elbow vein image has low contrast because of low image quality, uneven illumination intensity, and thicker subcutaneous fat. Therefore, it is difficult to extract a clear vein structure. To address this problem, a multiscale adaptive vein filtering enhancement method based on the Hessian operator is proposed. The method extracts veins from an image enhanced by contrast-limited adaptive histogram equalization with the use of an improved multiscale adaptive filter. The new filter structure can adaptively determine filter parameters based on the input image and suppress noise while extracting veins. The experimental results show that the method can effectively obtain a clear and complete vein structure, and it has stronger denoising, better enhancement effects, and higher accuracy.