Objective To investigate the clinical value of multi-slice spiral CT combined with MRI in the diagnosis of acute cerebral hemorrhage and postoperative reexamination. Methods 46 patients with acute cerebral hemorrhage admitted to Sichuan Meishan People's Hospital New District from May 2017 to March 2018 were examined by MRI and multi-slice spiral CT. The clinical and imaging data of 46 patients were collected and compared with the results of operation. The diagnostic accuracy of multi-slice spiral CT combined with MRI in acute cerebral hemorrhage was calculated. The value of MRI and CT examination in postoperative reexamination was analyzed. Results The diagnostic coincidence rate of multi-slice spiral CT and MRI in acute cerebral hemorrhage was 97.82%, significantly higher than that of single multi-slice spiral CT (80.43%) and single MRI (84.78%) (P<0.05). The DWI signal characteristics of the lesion and its surrounding areas were mainly mixed signals, accounting for 73.91% (34/46). In CT scan, the lesions showed clear edge, uniform density of high-density lesions, basal ganglia lesions showed high mixed density, the central region showed high density, surrounded by isodense or partial high-density shadows. The cost of CT reexamination was (246.36±36.95) yuan, significantly lower than that of MRI reexamination (691.64±47.42) (P<0.05). Conclusion Multi-slice spiral CT combined with MRI in the diagnosis of acute cerebral hemorrhage coincidence rate is high, patients with postoperative CT review is more economical and practical.