In order to improve the speed of compressed sensing image reconstruction algorithm, a two step rapid gradient projection for sparse reconstruction in medical image reconstruction is proposed. in traditional gradient projection for sparse reconstruction algorithm, the searching direction is alternate between the negative gradient direction when the direction is ill, the searching speed is slow. Now we search with two step gradient projection, the speed is increased when meets the ill-condition. Compared with the original GPSR algorithm, the TSGPSR algorithm not only accelerate the speed of operation, but also improves the accuracy of the reconstruction. and exhibits higher robustness under different noise intensities.