Objective To observe the application value of ultrasound and MSCT in diagnosing intracranial hemorrhage (ICH) in preterm infants. Methods The clinical data of 42 suspected ICH preterm infants were analyzed retrospectively. All patients were given ultrasound and MSCT. The diagnostic results were compared between the two methods. According to the diagnostic criteria for neonatal ICH, the diagnostic efficacy of ultrasound and MSCT were evaluated in ICH preterm infants. Results There was no significantly difference in the detection rates of IVH, SAH and SDH, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ICH preterm infants between ultrasound and MSCT (P>0.05), and the consistency of MSCT and comprehensive diagnosis was higher than that of ultrasound. The correlation of ultrasound and MSCT in diagnosing ICH preterm infants was statistically significant (P<0.05). The dominance was not statistically significant (P>0.05). Conclusion Preterm infants has high detection rate of IVH by ultrasound, and ultrasound has advantages of no radiation anf convenience. MSCT is superior to ultrasound in diagnosing SDH and SAH. The two methods have their own advantages and disadvantages, and the combined application can help the diagnosis of ICH in preterm infants timely and accurately.