Objective To analyze the clinical value of enhanced CT of intratumoral artery in differential diagnosis of intrahepatic cholangiocarcinoma and poorly differentiated hepatocellular carcinoma. Methods The clinical data of patients with intrahepatic cholangiocarcinoma (n=40) and poorly differentiated hepatocellular carcinoma (n=50) confirmed by pathology in our hospital from June 2013 to June 2015 were retrospectively analyzed. All patients underwent dynamic contrast enhanced CT scan and the imaging data were complete. The application value of enhanced CT scan in differential diagnosis of intrahepatic cholangiocarcinoma and poorly differentiated hepatocellular carcinoma was analyzed. Results Most of the signs of CT plain scan and enhanced scan in patients with ICC were lobulation signs (77.5%), intrahepatic bile duct dilatation (72.5%), arterial phase intratumoral hepatic artery (47.5%), annular enhancement (57.5%) and delayed enhancement (60.0%). The proportions were higher than that of patients with p-HCC and the differences were statistically significant (P<0.05). Conclusion Intratumoral hepatic artery, rapid clearance of contrast medium, lobulation signs, intrahepatic bile duct dilatation, arterial phase annular enhancement and delayed enhancement etc. are important CT signs for differential diagnosis of intrahepatic cholangiocarcinoma and poorly differentiated hepatocellular carcinoma which are the important basis for the differential diagnosis of the two.