Objective To analyze the application of contrast-enhanced ultrasound and multi-slice spiral CT in the diagnosis of hepatocellular carcinoma (HCC). Methods The imaging data of patients with HCC treated in the hospital between April 2015 and December 2017 were analyzed retrospectively. 120 patients with complete contrast-enhanced ultrasound and CT imaging data were selected as study subjects. The enhancement features and enhancement rates in aterial phase and portal phase, manifestations of HCC, assessment of vascular morphology, vascular imaging abundance and necrosis foci were compared between contrast-enhanced ultrasound and CT. Results There was no statistically significant difference in enhancement grade in arterial phase and portal phase or manifestations of HCC between contrast-enhanced ultrasound and CT (P>0.05). The ratios of enhancement rate of 0-1 and < 0 in arterial phase and enhancement rate < 0 in portal phase of contrast-enhanced ultrasound were lower than those of CT, while the ratio of enhancement rate in portal phase of 0-1 was higher than that of CT. The proportions of stripped irregular vascular morphology, rich vascular imaging and round-hole and patchy necrosis showed by contrast-enhanced ultrasound were higher than those by CT, while the proportions of thin and non-vascular vascular morphology, less vascular abundance and non necrosis were lower than those by CT. The positive rate of contrast-enhanced ultrasound was higher than that of CT (all P<0.05). Conclusion In the clinical diagnosis of HCC, the enhancement grade and manifestations of contrast-enhanced ultrasound in different phases are similar to those of CT. morphology can be obtained with CT in terms of at different phases. Compared with CT, contrastenhanced ultrasound has more advantages in assessing the vascular morphology, imaging abundance and positive rate.