Objective To investigate the application value of CT and B ultrasound in the initial diagnosis of primary hepatic carcinoma. Methods 59 patients with primary hepatic carcinoma confirmed by clinical pathology from September 2011 to September 2013 were retrospectively analyzed. All of the patients underwent B ultrasound and CT examination. The examination results and imaging findings were compared. Results The coincidence rate of CT examination (91.53%) was significantly higher than that of B ultrasound (76.27%). The detection rate of nodular lesions (93.75%) was significantly higher than that of B ultrasound (62.5%) (P<0.05). B ultrasound imaging showed that the massive type hepatic carcinoma had a low echo area which mainly were round and quasi-circular. The nodular lesions were of low density and without clear boundaries; CT imaging showed that the massive and nodular lesions were of low density and mainly were round and quasi-circular, without clear boundaries; Part of them were irregular and the density was homogeneous or not; The results of enhanced scan showed that the density of the lesion was enhanced and had clear boundaries with the surrounding tissues. Conclusion The accuracy of CT in diagnosis of primary hepatic carcinoma is high and it can be used as an important imaging method for initial diagnosis