Objective To investigate the changes of CT perfusion imaging parameters in elderly patients with hepatic fibrosis at different pathological stages. Methods 65 patients with hepatic fibrosis in the hospital were selected as the hepatic fibrosis group and 25 cases of healthy volunteers were selected as the control group. All of them received 64-slice spiral CT hepatic perfusion scanning. The amount of portal vein perfusion (PVP), hepatic arterial perfusion (ALP), liver perfusion index (HPI), blood volume (BV) and blood flow (BF) was recorded and was compared with clinical pathological stage. Results PVP, BF and BV of the hepatic fibrosis group were (92.26±6.25)ml·100ml-1·min-1,(41.09±3.55) ml·100ml-1·min-1 and (126.64±8.52)ml/L, respectively which were significantly lower than those of the control group while HPI (23.18±2.85)% was higher than that of the control group and the differences were statistically significant (P<0.05). At S1 stage, PVP, BF and BV were (102.24±3.28)ml·100ml-1·min-1, (45.64±1.36)ml·100ml-1·min-1 and (133.75±5.59)ml/L, respectively which were significantly higher than those at S3 and S4 stage while HPI (20.06±2.16)% was significantly lower than thatat S3 and S4 stage. The differences were significant (P<0.05). There was no significant difference between S1 and S2 stage, without statistical significance (P>0.05). Conclusion There is a significant correlation between 64-slice CT perfusion imaging parameters and the pathological stages of hepatic fibrosis in elderly patients.