Objective To explore the diagnostic value of transabdominal ultrasound and multi-slice spiral CT for adrenal adenoma. Methods The clinical and imaging data of 41 patients with adrenal adenoma treated in our hospital from June 2016 to April 2018 were retrospectively analyzed. To summarize the imaging findings of adrenal adenoma in transabdominal ultrasonography and multi-slice spiral CT. Results Abdominal ultrasonography in the diagnosis of adrenal adenoma and sensitivity detection rate 82.92%, 85.36% respectively, multilayer spiral CT in the diagnosis of adrenal adenoma and sensitivity detection rate 95.12%, 100% respectively, MDCT of adrenal adenoma was much higher than that of abdominal ultrasound (P<0.05), two kinds of inspection sensitivity compared to the diagnosis of adrenal adenoma had no statistical significance (P>0.05). Abdominal ultrasound showed smooth and bright boundary of the tumor body of aldosterone tumor and Cushing's tumor, with high echo around the tumor body, uniform low echo inside, and atrophy of the contralateral adrenal gland. Non-functional adrenal cortical adenoma had large tumors, complete membranes and normal contralateral adrenal expression. CT non-enhanced scan of adrenal adenoma usually presents irregular round soft tissue with uniform density nodules, with CT value of about 26HU, significant enhancement in arterial phase, continuous enhancement in venous phase and delayed phase. Conclusion The sensitivity of transabdominal ultrasound and multi-slice spiral CT in the diagnosis of adrenal adenoma is higher, and the detection rate of multi-slice spiral CT is higher than that of transabdominal voice.