Objective To investigate the diagnostic value of multislice spiral CT enhanced scan of the abdomen. Methods 116 cases of acute abdomen underwent 64 slice spiral CT scan and enhanced scan, data were transferred to workstation for reconstruction and observation methods, including multi planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR). Results In 116 patients, 42 cases of intestinal lesions, plain scan 18 cases were correctly diagnosed, enhanced scan 22 cases were correctly diagnosed. 16 cases of trauma, plain scan 13 cases were correctly diagnosed, enhanced scan 16 cases were correctly diagnosed; 16 cases of acute pancreatitis, plain scan 12 cases were correctly diagnosed, enhanced scan 12 cases were correctly diagnosed; 14 cases of urinary calculi, plain scan 14 cases were correctly diagnosed, enhanced scan 14 cases were correctly diagnosed. 12 cases of vascular lesions, plain scan 5 cases were correctly diagnosed, enhanced scan 12 cases were correctly diagnosed; 10 cases of biliary calculi, plain scan 14 cases were correctly diagnosed, enhanced scan 14 cases were correctly diagnosed. Conclusion The diagnostic value of Plain and enhanced CT scanning in acute pancreatitis and small stones was the same, for the diagnosis of vascular diseases, intestinal diseases and trauma, enhanced accuracy was higher than that of plain scan, enhanced scan has important clinical value in diagnosis of acute abdomen, it is worth popularizing in primary hospitals.