To propose a novel diffusion-weighted (DW) image denoising algorithm based on HOSVD to improve the signal-to-noise ratio (SNR) of DW images and the accuracy of subsequent quantization parameters. This HOSVDbased denoising method incorporated the sparse constraint and noise-correction model. The signal expectations with Rician noise were integrated into the traditional HOSVD denoising framework for direct denoising of the DW images with Rician noise. HOSVD denoising was performed directly on each local DW image block to avoid the stripe artifacts. We compared the proposed method with 4 image denoising algorithms (LR + Edge, GL-HOSVD, BM3D and NLM) to verify the effect of the proposed method. The experimental results showed that the proposed method effectively reduced the noise of DW images while preserving the image details and edge structure information. The proposed algorithm was significantly better than LR +Edge, BM3D and NLM in terms of quantitative metrics of PSNR, SSIM and FA-RMSE and in visual evaluation of denoising images and FA images. GL-HOSVD obtained good denoising results but introduced stripe artifacts at a high noise level during the denoising process. In contrast, the proposed method achieved good denoising results without causing stripe artifacts. This HOSVD-based denoising method allows direct processing of DW images with Rician noise without introducing artifacts and can provide accurate quantitative parameters for diagnostic purposes.