Objective To evaluate clinical contribution of MSCT in diagnosing nodular goiter (NG). Methods a total of 38 NG cases confirmed by postoperative pathology were enrolled. Performances of MSCT in each case were retrospectively analyzed. Results 22 cases presented multiple lesions, while 16 cases were solitary lesions. In plain scan, 29 cases showed low density or slight low density, 7 cases presented equal or slight high density and 2 cases were totally high density calcification. After enhancement, boundary of every lesion of each case could be clearly illustrated, and no case exceeded envelop. However, 5 cases showed tracheal compression. Cyst formation was seen in 25 cases, no enhancement was demonstrated, whereas circular enhancement was presented in peripheral. Mural nodules were seen in 2 cases, calcifications were demonstrated in 10 cases, and septal lines were identified in 8 cases. All the cervical lymph nodes were negative. Noncystic area showed inhomogeneous enhancement with different degree after contrast medium. Conclusion Inner structure, edge, feature of enhancement, and relationship with surroundings were clearly demonstrated by MSCT, which guarantee its clinical value in pre-operative evaluation on thyroid nodules.