Objective To explore the imaging and pathlogical features of CT in the diagnosis of lung adenocarcinoma. Methods The data of CT in 38 patients with lung adenocarcinoma confirmed by operation and pathology from Jan,2013 to Dec, 2015 were analyzed retrospectively. The diagnostic results of CT and pathology were compared and analyzed. Results 38 cases of this group of patients with lung adenocarcinoma, by CT diagnosis, cancer diameter varied from 10 to 64 mm,with the average level of (30±5)mm.Among them,20 cases were less than 20 mm while the others were larger than 20mm.CT images of chest showed that 15 cases belonged to poorly differentiated adenocarcinoma,and 10 cases moderately differentiated adenocarcinoma, In situ adenocarcinoma 7 cases (18.4%), micro infiltrating adenocarcinoma 6 cases (15.8%). Detection rate differences compared with surgical pathology confirmed results fit well, no statistical significance (P<0.05). Conclusion The CT imaging features of lung adenocarcinoma matched pathlogy of different carcinoma subtypes,which provides a believable method in the clinical diagnosis of lung cancer.