Objective To compare the application value of ultrasound and CT in the diagnosis of female pelvic cystic mass lesions. Methods The clinical data of 78 patients with pelvic masses confirmed by surgery and pathology who received treatment in the hospital during March 2012 to March 2015 were retrospectively analyzed. All the diagnostic data of ultrasound and CT of the patients were complete. The application value of ultrasound and CT in the differentiation of pelvic cystic mass lesions. Results Among the 78 cases of patients with pelvic masses, the accurate rates of ultrasound in detection of pelvic echinococcosis, cystic solidary ovarian cyst, uterine fibroid cystic lesion and ovarian cystadenocarcinoma were 60.0%, 60.0%, 50.0% and 60.0%, respectively and the accurate rates of localization were 40.0%, 52.0%, 50.0% and 60.0%, respectively. The accurate rates of CT in detection of pelvic echinococcosis, cystic solidary ovarian cyst, uterine fibroid cystic lesion and ovarian cystadenocarcinoma were 80.0%, 88.0%, 100.0% and 80.0%, respectively and the accurate rates of localization were 100.0%, 84.0%, 75.0% and 80.0%, respectively. The accurate rates of CT in the detection of above lesions were higher than those of ultrasound. Conclusion In the diagnosis of female pelvic cystic mass lesions, to adopt multi - slice spiral CT examination, the diagnostic accurate rate is high, with accurate positioning and high differentiation value. It is better than color Doppler ultrasound diagnosis and is worthy of promotion.