A general filtering method, called the singular value filter (SVF), is presented as a framework for principal component analysis (PCA) based filter design in medical ultrasound imaging. The SVF approach operates by projecting the original data onto a new set of bases determined from PCA using singular value decomposition (SVD). The shape of the SVF weighting function, which relates the singular value spectrum of the input data to the filtering coefficients assigned to each basis function, is designed in accordance with a signal model and statistical assumptions regarding the underlying source signals. In this paper, we applied SVF for the specific application of clutter artifact rejection in diagnostic ultrasound imaging. SVF was compared to a conventional PCA-based filtering technique, which we refer to as the blind source separation (BSS) method, as well as a simple frequency-based finite impulse response (FIR) filter used as a baseline for comparison. The performance of each filter was quantified in simulated lesion images as well as experimental cardiac ultrasound data. SVF was demonstrated in both simulation and experimental results, over a wide range of imaging conditions, to outperform the BSS and FIR filtering methods in terms of contrast-to-noise ratio (CNR) and motion tracking performance. In experimental mouse heart data, SVF provided excellent artifact suppression with an average CNR improvement of 1.8 dB (P <; 0.05) with over 40% reduction (P <; 0.05) in displacement tracking error. It was further demonstrated from simulation and experimental results that SVF provided superior clutter rejection, as reflected in larger CNR values, when filtering was achieved using complex pulse-echo received data and non-binary filter coefficients.