Objective To study the clinical application and limitation of curved planar reformation (CPR)technique of 64-row spiral CT in appendicitis. Methods To collect data of 235 patients with appendicitis diagnosed by surgery from July 2013 to February 2018 at the Fifth People's Hospital of Xuchang. All using SIEMENS SOMATOM Defense AS 64-row spiral CT to scan the lower abdomen. The 0.625mm thin layer scanning axial source image(ASI) is then transmitted to the image workstation for image post-processing, at the opening of the vermiform appendix in the lower cecum to reconstruct the enteric cavity all of the vermiform appendix, to make an arbitrary surface to clearly show the location of fecal-stone obstruction, the nature of obstruction, the distal appendix and the effusion, to identify and diagnose the cause of appendicitis, the results were compared with those of surgery and postoperative pathology. Results The 235 patients with suspected appendicitis, simple appendicitis in 192 cases and purulent appendicitis in 43 cases after the postoperative pathology confirmed. Curved planar reformation technique of 64-row spiral CT surface reconstruction technique can achieve 100% accuracy in the localization and qualitative diagnosis of appendicitis at preoperative. Conclusion The curved planar reformation technique of 64-row spiral CT can improve the preoperative diagnosis ability of patients with highly suspicious and atypical appendicitis, and reduce the occurrence of severe appendicitis for the diagnosis of appendicitis, and has high clinical value.