Objective To explore the clinical value of 64-slices spiral CTin detecting abdominal lymph node metastasis of esophageal carcinoma and abdominal cardiac carcinoma. Methods Preoperative CT images, clinical data and pathological result of abdominal esophageal carcinomas and cardiac cancers patients（66 cases） in our hospital from April 2010 to May 2011 were reviewed and analysed retrospectively, and three years of Postoperative follow-up was implemented. Results 202 abdominal cavity lymph nodes (SD≥10mm) were detected by 64-slice spiral CT, and the accuracy rate is 79.21% where as the accuracy rate is 16.78% for the abdominal cavity lymph nodes(SD<10mm). The result of chi-square shows the difference between them is significant（X2 =102.34, p<0.01. Thoracic esophageal cancer lymph node metastasis rate was significantly higher than that of abdominal cardiac carcinoma(X2 =7.78, P<0.01), abdominal lymph node metastasis rate of cardiac carcinoma was significantly higher than esophageal cancer (X2 =4.15, P<0.05). Survival rate at the first 3 years of follow-up was 45.6% for the patient whose metastasis lymph node number was between 1 and 4. And Survival rate at the first 3 years of follow-up was 0% for the patient whose the number of lymph node metastases is more than 4. Conclusion 64-slice spiral CT can accurately judge lymph node metastasis in patients, and provide a reference for the development of clinical programs. At the same time, it also can helps to determine the prognosis and could be applicated in clinical.