Objective To explore the clinical value of MSCT in the diagnosis of hip joint lesions. Methods CT scan was given to 120 cases of patients with hip joint lesions in our hospital, and the three-dimensional reconstruction images were analyzed. To observe the relationship between the three-dimensional shape of the lesion and the surrounding structures, and to compare with the routine X-ray results. Results The misdiagnosis rate of patients undergoing X-ray examination was 61.66%, among which 20 cases were missed diagnosis of fracture, 10 cases were missed diagnosis of tuberculosis, 19 cases were misdiagnosed of joint bone fragments, and 25 cases were missed diagnosis of joint bone fragments; The misdiagnosis rate of patients undergoing CT scan was 16.67%, among which 8 cases were missed diagnosis of fracture, 5 cases were missed diagnosis of tuberculosis, 4 cases were misdiagnosed of joint bone fragments, and 3 cases were missed diagnosis of joint bone fragments. To compare the two kinds of examination data, the difference was statistically significant(P＜0.05). Conclusion Compared with conventional limited display of X-ray on hip joint lesions, CT three-dimensional reconstruction imaging technology displays three-dimensional shapes of lesions in more intuitive manner, may clearly display the degree and displacement of complex fracture, and may serve as an imaging guidance for surgical approach and internal fixation. And the diagnosis of CT examination on patients with hip joint lesions is more accurate when compared with that of X-ray, being worthy of clinical application.