Objective To investigate the CT appearances of traumatic splenic rupture, and to improve the diagnostic accuracy of CT scan in the diagnosis of traumatic splenic rupture. Methods A retrospective analysis in our hospital from October 2007 to 2015 June were confirmed by operation of 48 cases of splenic rupture performance of CT scan and surgery is seen as the gold standard, by two experienced radiologists in a double blind method of spiral CT signs of systemic summary, the Cochran Armitage trend test was used for statistical analysis. <0.05 P was statistically significant. Results This group of 48 cases of splenic parenchyma increases, density is uniform in 30 cases, spleen blurry edge, not forty consecutive cases, spleen Zhou Shaoxu, 48 cases of massive effusion, spleen adjacent organ injury in 28 cases, liver week effusion, abdominal cavity and intestinal clearance effusion and left perisplenic rib fractures, left inferior pulmonary traumatic wet lung, left pleural effusion, diaphragmatic lift. Sensitivity and specificity were 90% (43/48), 98% (47/48). Conclusion Left upper abdominal trauma history, sweep spleen CT performance enlargement of the spleen parenchyma, uneven density, blurry edge, discontinuity and spleen week a little - large effusion, liver week effusion, abdominal cavity and intestinal clearance effusion, left rib fractures, left inferior pulmonary traumatic wet lung, left pleural effusion, left diaphragmatic elevation suggest that the spleen rupture, spleen and splenic marginal incomplete, uneven density, important direct sign symbol, perisplenic fluid important indirect signs, improve CT scan diagnosis of traumatic splenic rupture accuracy.