Objective To analyze the clinical value of enhanced CT in the diagnosis of thyroid cartilage involvement in patients with pharyngeal carcinoma. Methods 86 cases of patients with hypopharyngeal carcinoma who were treated in our hospital from January 2015 to January 2018were selected for the study and were confirmed by surgical pathology, and there were no missing CT imaging data before operation. The results of surgical pathology were taken as controls to compare the clinical value of enhanced CT in the diagnosis of thyroid cartilage involvement in patients with hypopharyngeal carcinoma. Results Among the 86 patients with hypopharyngeal carcinoma, 54 lesions were located in the pear-shaped vortex and showed a ring-shaped submucosal infiltration, of which 29 cases were invaded to aryepiglottic fold and laryngeal cavity and 19 cases were invaded to the paralaryngeal space and 6 cases were invaded to tongue root and pharynx oralis. 32 cases were located in the posterior pharyngeal wall with 27 cases of tumor outgrowth and 5 cases of invasive growth, and 14 cases infiltrated upward along the posterior pharyngeal wall and 18 cases infiltrated downward. The irregular soft tissue density unity block was seen in 71 cases, and extensively thickened pharyngeal wall was shown in 15 cases, and conventional CT plain scan showed 66 cases were of equal density or low density, and enhanced scan showed obvious uneven enhancement expression and clear boundary. 70 cases were with cervical lymph node metastasis and circular enhancement was seen in the enhanced scan, and 9 patients with larger lesions were with diffuse low-density shadow of neck. Compared with pathological results, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa value of enhanced CT in the diagnosis of thyroid cartilage involvement in patients with pharyngeal carcinoma were 64.28%, 89.65%, 81.39%, 75.00%, 83.87% and 0.560. Conclusion Enhanced CT has certain clinical value in the diagnosis of thyroid cartilage involvement in patients with pharyngeal carcinoma, and it deserves further investigation.