Objective To improve the accuracy rate of the diagnosis and differential diagnosis of inflammatory myofibroblastic tumor in the mediastinum by analyzing spiral computed tomography (CT) images. Methods Retrospective analysis of the clinical data and spiral CT features of 7 patients who had been confirmed inflammatory myofibroblastic tumor by postoperative pathology in the mediastinum. Results there was 1 patient whose lesions were in anterior mediastinum, 3 in middle mediastinum and posterior mediastinum respectively. All lesions were solid soft tissue mass. The case of anterior mediastinum had a clear boundary. The tumors of middle mediastinum did not have clear boundaries, two of the three invaded the right wall of trachea, while another one invaded esophageal wall. The tumor in right posterior mediastinum destroyed the structures of neighboring ribs, the other two cases in the posterior mediastinum have a clear boundary. A small amount of calcification was seen in the case of right posterior mediastinum. After administration of contrast material, mild, moderate and severe homogeneous enhancement patterns were found in 1,4,and 2 cases, respectively. Recurrence was found in 1 case. Conclusion Typical spiral CT imaging presentation of IMT in the mediastinum is as a soft-tissue mass with uniform density. A moderate homogeneous enhancement pattern is usually seen after administration of contrast material. Some lesions have clear boundaries, some do not. Spiral CT examination can help to determine lesion areas and relationship with adjacent tissues, and thus to facilitate the prediction of feasibility for surgical excision.