Objective To explore pathological features and CT features of patients with small intestinal tumor and tumor-like lesion. Methods A retrospective analysis of clinical data was carried out in 60 cases of small intestinal tumor and tumor-like lesion confirmed by surgery and pathology in our hospital from February 2013 to February 2016, pathological features and CT features of different tumors and tumor-like lesions were compared and observed. Results Pathological examination showed that there were 5 cases of malignant tumor, 35 cases of benign tumor, 20 cases of tumor-like lesion in 60 patients, they had characteristics of polypoid and protrusions toward enteric cavities, there were gastrointestinal tract interstitialoma focus under mucous membrane, fusiformis tumor cells, arrangements and trends were not the same; there were lipoma under mucous membrane, mucosa surface ulcer, cut surface of tumor were yellow; lymphatic tissue proliferative lens showed that focus occured in mucous layer, cell differentiation matured. Relevance ratio of CT in small intestinal tumor and tumor-like lesion were 90.00%, glandular cancer CT enhancement scanning showed the characteristics of rapid upstroke-platform, CT features of enteric lymphoma were bowel wall thickening, bowel stenosis, peritoneum and enlarged mesenteric lymph nodes; gastrointestinal tract interstitialoma mainly were grew outside the cavity, round or oval, the boundary between focus and ambitus normal intestinal wall was clear. Conclusion Most of small intestinal tumors are benign tumor, pathological features and CT features have an important value for diagnosis of small intestinal tumor and tumor-like lesion.