Objective To study the application value of high field MRI in the differential diagnosis of DN (dysplastic nodule) and SHCC (small hepatocellular carcinoma). Methods 18 cases (24 DN) and 15 cases (26 SHCC) treated from January 2014 to January 2016 in our hospital were selected. The MRI images were retrospectively analyzed. Results For 24 DN, there were 4 equi-signal cases in phase and opposed phase T1WI (16.67%) and 20 slightly high signal cases (83.33%), for 26 SHCC, there were 6 slightly high cases in phase T1WI (23.08%) including 3 low signal cases in opposed phase T1WI, there were 20 low signal or equi-signal cases in phase and opposed phase TlWI (76.92%). For 24 DN, there were 24 low signal cases on T2WIN, for 26 SHCC, there were 24 cases with heterogeneous equal signal, slightly high signal or high signal (92.31%) and 2 low signal cases on T2WI (7.69%). According to Gd-DTPA dynamic-enhanced scanning, DN group had 15 DN with slow rising and descending images (93.33%) including 13 DN with irregular reticular fiber reinforcement images (86.67%) and one DN with pseudocapsule reinforcement images; SHCC group had 24 SHCC with quick rising and descending images (92.31%) including 17 SHCC with enveloped reinforcement images (70.83%). Conclusion The high field MRI can efficiently reflect the clinical features of DN and early SHCC and make the differential diagnosis, which it is good to improve the diagnosis rate and determine the treatment schemes.