<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0201</schemaVersion>

    <documentType>4/A</documentType>

    <periodOfReport>2004-04-05</periodOfReport>

    <dateOfOriginalSubmission>2004-04-07</dateOfOriginalSubmission>

    <notSubjectToSection16>0</notSubjectToSection16>

    <issuer>
        <issuerCik>0001027702</issuerCik>
        <issuerName>EPIX MEDICAL INC</issuerName>
        <issuerTradingSymbol>EPIX</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001239463</rptOwnerCik>
            <rptOwnerName>WEBB MICHAEL D</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>71 ROGERS STREET</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>CAMBRIDGE</rptOwnerCity>
            <rptOwnerState>MA</rptOwnerState>
            <rptOwnerZipCode>02142</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>1</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle>Chief Executive Officer</officerTitle>
            <otherText></otherText>
        </reportingOwnerRelationship>
    </reportingOwner>

    <nonDerivativeTable>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Stock (Sale Pursuant to a 10b5-1 Trading Plan)</value>
                <footnoteId id="F1"/>
            </securityTitle>
            <transactionDate>
                <value>2004-04-05</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>S</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
                <footnoteId id="F2"/>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>500</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>21.45</value>
                    <footnoteId id="F1"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>D</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>135106</value>
                    <footnoteId id="F3"/>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
    </nonDerivativeTable>

    <derivativeTable></derivativeTable>

    <footnotes>
        <footnote id="F1">On April 7, 2004, the reporting person mistakenly filed a form 4 reporting a sale of 500 shares of common stock at $24.15.  This amendment is being filed to reflect that the sale price for the common stock should have been reported as $21.45.</footnote>
        <footnote id="F2">The sale reported on this Form 4 was effected pursuant to a Rule 10b5-1 Trading Plan adopted by the reporting person on November 26, 2003.</footnote>
        <footnote id="F3">Reporting person indirectly owns 2,500 shares of common stock through his spouse.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>Paula Valencia-Galbraith, Attorney-in-Fact</signatureName>
        <signatureDate>2004-04-08</signatureDate>
    </ownerSignature>
</ownershipDocument>

