Objective To analyze the application value of preoperative CT perfusion imaging in the surgical treatment of glioma patients. Methods A totaol of 81 patients with glioma undergoing craniotomy in neurosurgery department of our hospital from July 2014 to September 2017 were selected. According to the preoperative CT examination method, 45 patients were divided into perfusion group, 36 patients were rolled into the enhanced group. All of them were given CT perfusion and CT enhancement examination. The grading diagnosis was performed according to the size. CT perfusion or CT enhanced examination were performed after surgery, the recurrence of the two groups was compared. Results The preoperative CT perfusion tumor area in the perfusion group was (12.03±2.25) cm2 , significantly greater than the preoperative CT enhanced tumor area in the enhanced group (10.54±1.98) cm2 (P<0.05). Taking the postoperative pathological results as the standard, the diagnosis accuracy of low-grade and high-level in the perfusion group was significantly higher than that in the enhanced group (P<0.05). There was no significant difference in cerebral blood flow (CBF), cerebral blood volume (CBV) and CT enhancement value between the low-grade and high-grade patients in CT perfusion parameters of contralateral area (P>0.05), the CBF, CBV and CT enhancement values in the focal area of high-grade patients were significantly higher than those of the lowgrade patients (P<0.05). There was no significant difference in the recurrence rate (10.00% vs 27.78%) of the low-grade patients in the perfusion group and the enhanced group (P>0.05), the recurrence rate of the high-grade patients in the perfusion group within 1 year (16.00% vs 44.44%) was significantly lower than that in the enhanced group (P <0.05). Conclusion Preoperative CT perfusion imaging helps to define the extent of glioma lesions, and improve the diagnostic accuracy of preoperative grading, and reduce the postoperative recurrence rate.