Abstract ‘Speckle’ refers to the granular patterns that occur in ultrasound images due to wave interference. Speckle removal can greatly improve the visibility of the underlying structures in an ultrasound image and enhance subsequent postprocessing. We present a novel framework for speckle removal based on low-rank non-local filtering. Our approach works by first computing a guidance image that assists in the selection of candidate patches for non-local filtering in the face of significant speckles. The candidate patches are further refined using a low-rank minimization estimated using a truncated weighted nuclear norm (TWNN) and structured sparsity. We show that the proposed filtering framework produces results that outperform state-of-the-art methods both qualitatively and quantitatively. This framework also provides better segmentation results when used for pre-processing ultrasound images.