Objective To analyze the CT scanning and VR reconstruction imaging feature analysis of renal hamartoma and improve diagnostic rate, relevance ratio of renal hamartoma. Methods 40 cases of renal hamartoma in our hospital from February 2015 to February 2016 were selected. Male 15 cases (37.50%), female 25 cases (62.50%). They were given CT scanning, maintained at supine position, scanned area from crista ilii to diaphragmatic dome, non-ionic contrast media was given by high pressure syringe group through the upper limb vein, 300mg I/ml, dosage 80-100ml, injection speed 2.5~3.0ml/s, MSCT, screw pitch was 1.25, VR reconstruction was given after routine scan and enhancement scan. Results Of 40 cases, 25 right kidney, 13 left kidney, 2 right kidney. Focus diameter range 2.0-9.6 cm. CT scanning feature: mixed density lump, low density mass. CT enhancement scan feature: smooth muscle and vascular component showed strengthen of different degree, tumor hemorrhage stove and fat density focal existed no obvious strengthen. VR reconstruction: clearly showed renal artery and its branch, distribution situation, stenosis or not in blood vessel intracavity, plaque and calcification. Conclusion Small lesion of renal hamartoma has no obvious symptoms and it has distinctive imaging finding. CT scanning, enhancement scan can clearly detect renal hamartoma small lesion. CT three-dimensional reconstruction can confirm renal hamartoma and intratumoral hemorrhage. It can improve detection rate and accuracy of renal hamartoma and lower misdiagnosis and missed diagnosis.