Objective To explore the diagnostic value of color Doppler ultrasound (ultrasound) combined with computed tomography (CT) in localization and quantitative diagnosis of adrenal space-occupying lesions. Methods The clinical data of 112 patients with adrenal lesions diagnosed by pathological examination in our hospital were analyzed retrospectively. The localization diagnostic accuracy and quantitative diagnostic accuracy of ultrasound, CT and combined diagnosis were compared among 112 cases. Results There were 64 cases (57.14%) of adrenocortical tumors and 48 cases (42.86%) of adenomedullary tumors in 112 cases of adrenal lesions. There was no significant difference in the localization diagnostic accuracy between ultrasound and CT (P>0.05), but the accuracy of combined diagnosis was significantly higher than that of ultrasound or CT (P<0.05). The quantitative diagnostic accuracy of CT was higher than that of ultrasound (P<0.05), but the accuracy of combined diagnosis was significantly higher than that of ultrasound or CT (P<0.05). Conclusion Both ultrasound and CT are important in the diagnosis of adrenal lesions, but the combined diagnosis of the two examinations can improve the localization accuracy and quantitative accuracy, and can determine the nature of lesions more accurately, and provide the basis for selecting the best clinical treatment regimen.