Abstract In this paper, we propose a new non-rigid robust registration method that registers a point distribution model (PDM) of a surface to given 3D images. The contributions of the paper are (1) a new hierarchical statistical shape model (SSM) of the surface that has better generalization ability is introduced, (2) the registration algorithm of the hierarchical SSM that can estimate the marginal posterior distribution of the surface location is proposed, and (3) th registration performance is improved by (3-1) robustly registering each local shape of the surface with the sparsity regularization and by (3-2) referring to the appearance between the neighboring model points in the likelihood computation. The SSM of a liver was constructed from a set of clinical CT images, and the performance of the proposed method was evaluated. Experimental results demonstrated that the proposed method outperformed some existing methods that use non-hierarchical SSMs.