The photon point clouds collected by the high-sensitivity single-photon detector on the Ice, Cloud, and Land Elevation Satellite-2 (ICESat-2) are utilized in various applications. However, the discretely distributed noise among the signal photons greatly increases the difficulty of signal extraction, especially the edge noise adjacent to signals. To detect signal photons from vegetation coverage areas at different slopes, this paper proposes a density-based multilevel terrain-adaptive noise removal method (MTANR) that identifies noise in a coarse-to-fine strategy based on the distribution of noise photons and is evaluated with high-precision airborne LiDAR data. First, the histogram-based successive denoising method was used as a coarse denoising process to remove distant noise and part of the sparse noise, thereby increasing the fault tolerance of the subsequent steps. Second, a rotatable ellipse that adaptively corrects the direction and shape based on the slope was utilized to search for the optimal filtering direction (OFD). Based on the direction, sparse noise removal was accomplished robustly using the Otsu's method in conjunction with the ordering points to identify the clustering structure (OPTICS) and provide a nearly noise-free environment for edge searching. Finally, the edge noise was removed by near-ground edge searching, and the signal photons were better preserved by the surface lines. The proposed MTANR was validated in four typical experimental areas: two in Baishan, China, and two in Taranaki, New Zealand. A comparison was made with three other representative methods, namely differential, regressive, and Gaussian adaptive nearest neighbor (DRAGANN), used in ATL08 products, local distance statistics (LDS), and horizontal ellipse-based OPTICS. The results demonstrated that the values of the F1 score for the signal photon identification achieved by the proposed MTANR were 0.9762, 0.9857, 0.9839, and 0.9534, respectively, which were higher than those of the other methods mentioned above. In addition, the qualitative and quantitative results demonstrated that MTANR outperformed in scenes with steep slopes, abrupt terrain changes, and uneven vegetation coverage.