Objective To investigate the consistency between TNM staging and pathological results of non-small cell lung cancer (NSCLC) by multislice spiral CT. Methods Data of 84 patients with NSCLC treated in our hospital from January 2012 to June 2017 were retrospectively analyzed. All patients received preoperative multi-slice spiral CT examination and pathological examination. Results The total coincidence rate in T staging of CT and pathology was 83.33% (82/84, Kappa=0.79). 1 CT-T4 staging patients reduced to T3according to the pathological results. Among the 14 CT-T3 patients, one patient had non-aortic involvement confirmed by pathology, two patients were diagnosed as T4. Of patients with CT-T2, 5 patients involved mediastinal pleura after operation, and 3 patients involved pericardium during the operation were diagnosed as T3; Among NSCLC patients, 18 had postoperative lymph node metastases, and the T staging was consistent with the pathological findings (Kappa=0.51). The pathology of CT-N0 patients had confirmed 10 cases of lymph node metastasis in N1, and 2 cases of mediastinal lymph node metastasis. Of CT-N1 patients, no lymph node metastasis was found in 8 patients and 3 cases having mediastinal lymph node metastases were diagnosed as N2 stage. 3 cases involved intraoperative exploration and hilar lymph node metastasis were diagnosed as N1. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MSCT were different in lymph node metastases of all groups. Conclusion Multi-slice spiral CT is of great significance in the diagnosis of TNM staging of non-small cell lung cancer, and it can be used as an important basis for assessing whether the patients can receive surgical treatment