Objective To analyze the findings of CT enhanced scan of acute necrotizing pancreatitis and their diagnostic value. Methods The clinical data of 56 patients with acute necrotizing pancreatitis who were admitted to the hospital from October 2016 to May 2018 were retrospectively analyzed. CT enhanced scan was performed within 3 days after onset, and the imaging findings and diagnostic value were analyzed. Results The CT grade of 156 patients with Baltha method showed 7 cases of grade A, 7 cases of grade B, 13 cases of grade C, 20 cases of grade D and 9 cases of grade E. Imaging findings included pancreatic volume showing local or general increase and swelling, inhomogeneous density, visible spotted or patchy distribution of low-density zone or increased density shadows in decreased density zone, irregular shape of the pancreas, homogeneous enhancement with or without patchy high-density shadow density-reduction zone, blurred outline of fat adjacent to pancreas and fat layer disappearing. The enhanced scan of pancreas showed obvious enhancement, without obvious enhancement zone in necrotic part and with obviously enhancement of normal tissue. The CT values of grade I, grade II, grade III and grade IV in the decreased liver CT value group were significantly lower than those in the normal liver CT value group (P<0.05). Conclusion CT enhanced scan is of certain diagnostic value for acute necrotizing pancreatitis, which can guide the development of follow-up treatment plan and improve the prognosis.