Objective To explore the CT characteristics of intrahepatic biliary cystadenocarcinoma and improve the diagnostic level. Methods Analyze he CT data of 7 cases of intrahepatic biliary cystadenocarcinoma which confirmed by surgery and pathology retrospectively. Results All of the 7 cases were single cystic tumors, 4 cases in the left lobe of the liver, 2 cases of the right lobe of the liver, and 1 cases involving the left and right leaves. 3 cases were confined inside the liver while 4 cases were out of the hepatic outline. The maximum diameter of all tumors was 4.8 to 18.5 cm , 2 cases were single cavity and with oval shape, 5 cases were multiple cavities and showed irregular shape and with lobes. The boundary of 3 cases were clear while the rest 4 cases were unclear. The wall of the cystic wall of the lesion was uneven on unenhanced CT, the cystic wall of all 7 tumors were heterogeneous in thickness, obvious wall nodules can be seen in 6 tumors, spotted calcification of cystic wall can be seen in 2 tumors. The septum inside multiple cavities were heterogeneous in thickness, a little of solid tissue with mild low density can be seen in 2 cases of huge tumors. The cyst fluid of 5 tumors showed heterogeneous density and the CT value were 11-29HU while the rest 2 tumors showed uniform density and the CT value were 4-8HU. On enhanced CT, the cystic wall and septum showed mild enhancement in artery phase, and continued heterogeneous moderate enhancement in portal vein and delayed phase; the wall nodules of 5 cases showed delayed enhancement continuously, while the wall nodules of 1 tumor showed obvious enhancement unevenly in artery phase, and the enhancement decreed in portal vein and delayed phase. Adjacent intrahepatic biliary of 3 tumors showed mild enlargement, the common bile duct of 2 tumors showed mild enlargement, 1 tumor accompanied with multiple swollen lymph nodes in the abdominal cavity and retroperitoneum, ascites can be seen in 2 tumors. Conclusion The CT features of intrahepatic biliary cystadenocarcinoma are of certain characteristics. It is of great value to recognize the imaging features for diagnosis and differential diagnosis.