This article delves into a medical image encryption/decryption method based on hyper chaotic dynamics and genetic algorithms. The proposed algorithm boasts simplicity in implementation, featuring straightforward operations that render it well-suited for real-time applications while elevating its security measures. Leveraging the sensitivity of chaotic behavior to initial conditions, a genetic algorithm is employed to select optimal initial conditions for the 5D multi-wing hyper-chaotic system. Initially, a secret key generation method based on the input image is applied, followed by stages of diffusion and encryption utilizing the chaotic system. The secret key undergoes optimization through a genetic algorithm, considering specific parameters within the encrypted image as encryption factors. Subsequently, the encrypted image with the optimized secret key is finalized, serving as the basis for decrypting the cipher image. The proposed method undergoes simulation, testing, and comparison against other image encryption algorithms. Both experimental results and computer simulations affirm the robustness of this cryptographic system, showcasing a significant key space value (2^256), high key sensitivity (Number of Pixels Change Rate: NPCR > 99.55%, Unified Average Changing Intensity: UACI > 33.37%), and its ability to fend off various types of attack.