Objective To explore the value of CT scan combined with detection of tumor marker levels in the diagnosis of patients with hepatic carcinoma. Methods 57 patients with primary hepatic carcinomas (PHC) confirmed by pathological examination in our hospital between April 2013 and April 2015 were selected as the study object and were included in the observation group. All the patients underwent pathological examination, laboratory examination and CT scan. Another 40 patients with benign hepatic carcinomas and 40 healthy volunteers who were admitted into the hospital in the same period were included in the control group B and control group C, respectively. The levels of carcinoembryonic antigens (CEA) and alpha fetal protein variants 3 (AFP-L3) were recorded. The results of pathological examination were taken as the golden standard to evaluate the differences in accuracy rates of single CT scan, single tumor marker examination and the combined examination in the clinical diagnosis of hepatic carcinomas and differential diagnosis of benign and malignant carcinomas. Results The differences in levels of serum CEA and AFP-L3 and positive rates between the observation group, control group B and C were statistically significant (P<0.05); Besides, the observation group > control group B > control group C (P<0.05). The accuracy rates of CT scan, detection of tumor marker levels and the combined examination in the clinical diagnosis of hepatic carcinomas were 85.4% (117/137), 73.0% (100/137) and 95.6% (131/137), respectively; The accuracy rates of the above mentioned three methods in the differential diagnosis of PHC were 83.5% (81/97), 68.0% (66/97) and 94.9% (92/97), respectively. Conclusions CT scan combined with detection of tumor marker levels can effectively improve the accuracy of early diagnosis of patients with PHC and it is good for the successful development of follow-up targeted treatment.