Objective To investigate the ultrasound and CT features of patients with hepatocellular carcinoma (HCC). Methods The clinical data of 126 patients with HCC admitted to the hospital from February 2012 to February 2017 were retrospectively analyzed. The patients were examined by ultrasound (ultrasound group, n=65) and CT (CT group, n=61). The imaging signs were compared between the two groups, and the efficiencies of ultrasound and CT in the diagnosis of HCC were analyzed. Results The sensitivity, specificity and accuracy of CT in the diagnosis of HCC were 80.39%, 80.00% and 80.33% respectively, while those of ultrasound were 77.36%, 83.33% and 78.46% respectively (P>0.05). Contrast-enhanced CT showed fast in and fast out enhancement characteristics. Lesions showed different degrees of enhancement, high or equal density in arterial phase, weakened enhancement, slightly higher, equal or low density in portal phase, weakened enhancement and low density in balance phase. The main manifestation of ultrasound examination was fast in and fast out enhancement pattern. Lesions showed highly enhanced signals in arterial phase, low enhancement in portal phase and lesions basically cleared in the delayed phase. Conclusion The ultrasound and CT images of patients with HCC are characteristic. The efficiencies of the two are similar in the differential diagnosis of benign and malignant HCC. They are of certain application value in differential diagnosis of benign and malignant HCC.