Objective To investigate the significance of MSCT in the prediction, prevention and dynamic observation of cerebral hyperperfusion syndrome (CHS). Methods The clinical and imaging data of 8 patients with CHS were analyzed retrospectively. Results In 8 cases, 1 cases occurred after arterial thrombolysis and DSA screening after the operation, 3 cases of carotid artery stenting and coil embolization of aneurysm after operation. Were observed in the ultra-early (1 hour) and early (within 24 hours), middle (1 to 5 days) and late (> 5 days) of MSCT dynamic performance: 4 cases of cerebral infarction patients with ultra-early occurrence of acute cerebral hemorrhage, 3 cases of cerebral hemorrhage absorbed gradually; 1 cases intracerebral hemorrhage in early stage and increased with cerebral hernia formation, middle and late gradually increased after death. In 4 cases after cerebral hemorrhage patients, 2 cases of ultra-early appeared cerebral edema and swelling, thereafter gradually absorbed to restore; 1 with gradual increase in the amount of bleeding, advanced slightly to absorb; the other 1 case bleeding in super early period increased markedly and brain edema and brain swelling, followed by symptoms non improvement. The family eventually gave up treatment after death. Conclusion MSCT in prediction and prevention of CHS, the development has an important value, should be included in the routine examination; MSCT dynamic observation is display CHS evolution process of the most reliable and the most intuitive means of inspection, can provide an important basis for treatment and prognosis.