Objective To analyze the clinical features and imaging features of 30 patients with reversible posterior leukoencephalopathy syndrome (RPLS), and provide reference for the diagnosis and treatment of the disease. Methods Thirty patients with RPLS treated in our hospital between July 2014 and September 2015were selected as study subjects. All patients were examined by CT and MRI, and their clinical data were collected. The clinical features, imaging features and the sensitivity, specificity and accuracy of CT combined with MRI in the diagnosis of RPLS were analyzed. Results RPLS showed acute onset and the mainly manifestations included epilepsy (26.67%), headache and dizziness (20.00%), convulsion (23.33%), blurred vision (6.67%), disturbance of consciousness (10.00%) and nausea and vomiting (13.33%), may beingcomplicated with hypertension and renal injury. CT showed low density shadow under cerebral cortex. MRI showed equal or slightly low signal on T1WI, high signal on T2WI and FLAIR. After treatment, patchy high signal in bilateral occipital lobes and right basal nucleus region was significant absorbed and improved; The sensitivity, specificity and accuracy of CT combined with MRI in the diagnosis of RPLS (91.67%, 83.33%, 90.00%) were higher than those of CT (66.67%, 83.33%, 70.00%) and MRI (79.17%, 66.67%, 76.67%), and the sensitivity of CT was the lowest (P<0.05). Conclusion The main manifestations of RPLS are epilepsy, convulsions, headache and dizziness. CT shows low density shadows under the cerebral cortex, while the MRI-T1WI shows equal or slightly low signal and T2WI and FLAIR show high signal.