Sign recognition is important for identifying benign and malignant nodules. This paper proposes a new sign recognition method based on image retrieval for lung nodules. First, we construct a deep leing framework to extract semantic features that can effectively represent sign information. Second, we translate the high-dimensional image features into compact binary codes with principal component analysis (PCA) and supervised hashing. Third, we retrieve similar lung nodule images with the presented adaptive-weighted similarity calculation method. Finally, we recognize nodule signs from the retrieval results, which can also provide decision support for diagnosis of lung lesions. The proposed method is validated on the publicly available databases: lung image database consortium and image database resource initiative (LIDC-IDRI) and lung computed tomography (CT) imaging signs (LISS). The experimental results demonstrate our retrieval method substantially improves retrieval performance compared with those using traditional Hamming distance, and the retrieval precision can achieve 87.29%when the length of hash code is 48 bits. The entire recognition rate on the basis of the retrieval results can achieve 93.52%. Moreover, our method is also effective for real-life diagnosis data.