Objective To analyze the value and imaging features of enhanced CT combined with ultrasound in the preoperative identification of benign and malignant ovarian lesions. Methods The imaging data of 300 patients with ovarian lesions admitted to our hospital from March 2014 to August 2017 were analyzed retrospectively. The results of pathological examination were taken as criterion to evaluate the value of enhanced CT combined with ultrasound in the identification of benign and malignant ovarian lesions. Results Pathological examination results showed that there were 81 cases of malignant tumors and 219 cases of benign tumors among 300 patients with ovarian tumors, and there were 53 cases of unilateral lesions and 28 cases of bilateral lesions among 81 patients with malignant tumors. There were 23 cases patients with lymph node metastasis and 41 cases with invasion of surrounding organs. The diagnostic sensitivity, specificity and accuracy of CT were 87.21%, 81.48% and 85.67%, and CT examination could effectively diagnose the lesion location, detect the lesion density, suggest the internal structure and morphological characteristics of lesion, and metastasis, and had obvious signs of lesion metastasis. And malignant lesions were with obvious enhancement in capsule wall and interval, and unevenly enhanced solid components during enhanced scan. The sensitivity, specificity and accuracy of ultrasound were 93.15%, 92.59% and 93.00%, respectively. The ultrasonic examination methods were various and could effectively show the features of lesion morphology, structure and internal blood flow signal. The sensitivity, specificity and accuracy of enhanced CT combined with ultrasound were 96.35%, 97.53% and 96.67%, respectively. Conclusion Enhanced CT combined with ultrasound can increase the deficiency of simple examination, and effectively improve the diagnostic effects of benign and malignant ovarian tumors, thus it is worthy of clinical promotion.