Objective To explore the multi-slice spiral CT (MSCT) manifestations of patients with neuroendocrine neoplasia (NET) and liver metastases and the treatment effects of transcatheter arterial chemoembolization (TACE) combined with chemotherapy. Methods The clinical data of 162 cases of patients with NET and liver metastases in our hospital from June 2014 to June 2017 were retrospectively analyzed. All patients were given the MSCT and were divided into the observation group (n=90, chemotherapy and TACE) and the control group (n=72, chemotherapy). The efficacy of the two groups was compared, and the MSCT manifestations were analyzed before and after treatment. Results ① The total effective rate in the observation group was higher than that in the control group (P<0.05). ② Before treatment, CT plain scan showed there were uniform or non-uniform slightly low density, and some patients with unclear border lesions or some undisplayed lesions. Enhanced scan of different diameter lesions showed different manifestations, and continuous enhancement was in arterial phase and portal phase, and portal phase was mainly with equal density enhancement, and the enhancement degree of lesions in delayed phase was much lower than that in liver parenchyma. ③ After treatment, the volume of enhanced scan lesion in patients with effective treatment was smaller than that before treatment, and the volume in patients with SD and PD was not shrinked or increased compared with that before treatment but tumor edge was partial enhancement. Conclusion TACE combined with chemotherapy can have significant effects on NET liver metastasis, and MSCT has more positive significance in the differential diagnosis and guidance of NET liver metastasis.