Objective To compare the application value between transvaginal ultrasonography and multi-slice spiral CT (MSCT) scan in the diagnosis of gynecological pelvic tumors. Methods 186 patients with gynecological pelvic tumors who were treated in our hospital from May 2015 to May 2018 were enrolled in the study. All relevant imaging data of patients were collected.The postoperative results of biopsy were used as the diagnostic criteria, and the diagnostic accuracy of different examination for gynecological pelvic tumors was summarized. Results The correct rate of MSCT examination for gynecological pelvic tumor was 93.55%, which was significantly higher than that of transvaginal ultrasonography (86.02%) (P<0.05). The lesions of most of hysteromyoma in the ultrasonography show hypoechoic. The lesions of benign ovarian tumors have clear edges, and there is no echo inside the lump. Inhomogeneous and hypoechoic mass can be seen in cervical cancer and ovarian cancer,with unclear borders. In the MSCT enhanced scan. The lesions of hysteromyoma showed obvious uniform enhancement, and calcification and necrosis were observed in the center. Benign ovarian tumors showed a sharp boundary in the MSCT plain scan, showing a thin-wall and watery density, and obvious reinforcement was not seen after further enhancement of scanning surface. Inhomogeneous and hypoechoic mass can be seen in cervical cancer and ovarian cancer through ultrasonography ,with unclear borders.The cervical cancer showed irregular form in further enhanced scanning of MSCT, showing uneven density shadow, with irregular and blurry edges.A plain scan of the ovarian cancer showed that the outer wall of the lesion was papillary, and obvious reinforcement was seen after further enhancement scan. Conclusion MSCT diagnosis of gynecological pelvic tumors has a high correct rate, especially for benign lesions. it is worthy of being one of the first choice of imaging examination for gynecological pelvic tumors in clinic.