Objective To investigate the CT diagnosis method of spiral features and clinical significance on the elderly patients with vasogenic acute abdomen. Methods A retrospective analysis of February 2014 to January 2015 in our hospital emergency department emergency elderly patients with acute abdomen, select simultaneously both ultrasound and multi-slice spiral CT examination and a clinical diagnosis of acute abdomen bloodborne 36 patients. Compare the accuracy of two diagnostic methods. Results Ultrasound diagnosis of abdominal aortic aneurysm five cases, arterial dissection eight cases, one case of superior mesenteric vein thrombosis, arterial thrombosis of the superior mesenteric two cases, renal artery and its branches embolism four cases, three cases of portal vein thrombosis, pseudoaneurysm three cases. Multislice spiral CT diagnosis of abdominal aortic aneurysm five cases, arterial dissection eight cases, two cases of superior mesenteric vein thrombosis, arterial thrombosis of the superior mesenteric three cases, five cases of mesenteric twist, renal artery and its branches embolism four cases, six cases of portal vein thrombosis, pseudoaneurysm three cases.Ultrasound diagnostic accuracy rate of 72.2%. Spiral CT diagnostic accuracy was 100%, by statistical comparison of two diagnostic accuracy of the method was significantly different (χ2=11.61, P<0.01). Conclusion Spiral CT angiography diagnosis method has good effect in elderly emergency vascular acute abdomen, determining significance of the lesions and vascular conditions.