Objective To analyze the CT features and the diagnostic value of gliomas and cerebral hemorrhage. Methods A retrospective analysis was performed on 30 patients with gliomas and 30 patients with cerebral hemorrhage who were initially diagnosed in the hospital during the period from July 2015 to February 2018. CT features, cerebral perfusion associated parameters cerebral blood flow(CBF), regional cerebral blood volume(CBV), mean transit time(MTT) and permeability surface(PS) were compared. Results Of the 30 cases of gliomas, 13 cases were located in limbic brain, 10 cases in cerebral cortex and 7 cases in basal ganglia region. The shapes of hemorrhagic foci were not regular, and different in size. There were 9 cases of subarachnoid hemorrhage, showing high-density shadows with clear and sharp edges. There were 17 cases of high-density hemorrhage covered soft tissue, 8 cases of high-density hemorrhage with cystic changes, 24 cases of edema around the lesion and 21 cases of obvious mass effect. Enhanced scan showed that the lesions were enhanced in different degrees, and the enhancement mainly was ring-like (13 cases), flake-like (8 cases) or nodular (9 cases). In 30 cases of cerebral hemorrhage, 21 cases were located in the basal ganglia region, 4 cases in the cerebellum, 3 cases in the brainstem, 2 cases in the lobe and 2 cases in the ventricle. CT showed highdensity homogeneous shadows and they were quasi-circular. There were 4 cases of mild edema around the hemorrhage and enhanced scan showed no obvious enhancement. There was no significant difference in CT values between the two kinds of lesions (p>0.05). Lesions of gliomas were not specific, and the cerebral hemorrhage was mostly located in the basal ganglia region. Cases with obvious edema around the lesion and mass effects are significantly more than those in patients with cerebral hemorrhage. CBF, CBV, MTT and PS were significantly lower than those of cerebral hemorrhage (P<0.001). Conclusion The CT images of gliomas and cerebral hemorrhage are significantly different in location, edema and mass effect, and the parameters related to cerebral perfusion are also specific, which provides high-value references for the diagnosis and differential diagnosis.