Objective To investigate the diagnose and identification value of 16-slice spiral CT on thyroid disease. Methods 42 cases with thyroid disease diagnosed by surgery and laboratory inspection in our hospital from January 2013 to January 2014 were selected. Their clinic data were selected, compare diagnostic coincidence rate of different types of thyroid disease and different types of thyroid disease. Results Compare the CT results and biopsy of 42 cases, diagnostic coincidence rate was 95.23%(40/42), diagnostic coincidence rate of CT on malignancy was 91.66%(11/12)and on benign disease was 96.66%(29/30). Benign and malignant thyroid can be diagnosed by diolame is complete or not, focus form, peripheral tissues well-defined or not. CT image features of malignant thyroid: nuclear ledge, irregular shape, tiny calcified points and nonencapsulated. Conclusion 16-slice spiral CT can showthyroid disease changes clearly and has higher diagnostic coincidence rate of different types of thyroid disease. Doctors should know features of different types of thyroid disease, it has important significance on diagnose and identification.