Objective To investigate the multi-slice spiral CT imaging features of sarcomatoid carcinoma of the lung. Methods 21 patients with sarcomatoid carcinoma of lung in our hospital May 2014 to December 2015 were selected, at the same time 20 cases of non sarcomatoid lung from cancer were collected, the imaging data and clinical data of two groups of patients were analyzed and the CT scan images of patients with sarcomatoid carcinoma of lung were analyzed. The imaging features of pulmonary sarcomatoid carcinoma in multi-slice spiral CT scan were summarized. Results 21 patients with sarcomatoid carcinoma, 95.23% (20/21) were solitary lesions, the distribution of tumor is common in peripheral area, circular or agglomerate; the diameter of tumor was >4.0cm, MSCT images showed cystic necrosis, the cystic area is larger, the common spinous process sign is different from burr sign, there is a cavity or irregular air space in its mass; the enhancement value was only(31.00±7.66)Hu, Significantly lower than non sarcomatoid lung cancer(54.11±7.81)Hu. The data difference was statistically significant(P<0.05). Conclusion The MSCT scan of sarcomatoid carcinoma of lung has certain characteristics. Multi-slice spiral CT is helpful in differentiating lung sarcomatoid carcinoma from non sarcomatoid lung cancer, definitive diagnosis of sarcomatoid carcinoma of the lung and imaging data for clinical treatment options.