Objective To investigate the value of multi-slice spiral CT (MSCT) plain scanning and three-phase dynamic contrast-enhanced scanning in the diagnosis of hepatocellular carcinoma. Methods CT findings of 52 patients with hepatocellular carcinoma confirmed by surgery and pathology collected from March 2015 to March 2017 were analyzed retrospectively. The CT and CT scanning were analyzed retrospectively. Results ①There was a total of 82 liver cancer lesions detected in 14 patients with cirrhosis by using 128-slice spiral CT multi-phase contrast-enhanced scan. The lesion displayed a slightly lower density on plain scan, scan lesions in the "fast forward fast" typical enhancement, manifested as arterial phase enhancement, 3 lesions were not significantly enhanced arterial phase; portal phase gradually decreased, the delay period showed low density. Compared with the results of surgical pathology, the comprehensive detection rate of three stages of 64-slice 128-slice spiral CT multi-phase enhanced scan was as high as 100%. ②The detection rate of three-phase dynamic enhanced CT scan of hepatocellular carcinoma by multi-slice spiral CT were as follows: the detection rate of arterial phase was 96.34%, the detection rate of portal phase was 82.92%, the detection rate of delayed phase was 87.80%. Conclusion In the clinical diagnosis of hepatocellular carcinoma, 64 rows of 128-slice spiral CT multi-phase enhanced scan can clearly reflect the characteristics of blood supply of hepatocellular carcinoma and provide a reliable imaging basis for the early diagnosis of hepatocellular carcinoma. Hepatocellular carcinoma diagnosis and disease monitoring has important clinical significance.