Objective To explore the diagnostic values of CT for small hepatocellular carcinoma (SHCC) related to hepatitis B cirrhosis. Methods The clinical data of 73 cases of patients with hepatitis B cirrhosis-associated SHCC in our hospital were analyzed retrospectively. And they were given the CT plain scan and enhanced scan for liver preoperatively. The pathological results were taken as the gold standard to analyze the diagnostic values of CT for hepatitis B cirrhosis-associated SHCC. Results Among the 73 patients, 59 (64.13%) cases of SHCC cancer were detected by CT plain scan and 85 (92.39%) cases were detected by CT enhanced scan, and the detection rate of CT enhanced scan was significantly higher than that of plain scan (P<0.05). Among them, 60 cases were single lesions and 13 cases were multiple lesions. The morphology of the lesion was round with the diameter of 0.6-3.0 (2.09±0.65) cm. 54 cases were distributed in right lobe of liver and 19 cases in left lobe of liver. There were 3 high density, 56 low density and 34 equal density by CT plain scan. In the hepatic artery phase, 84 (91.30%) cancer foci were detected, 63 in high density (markedly uniform enhancement), 17 in edge enhancement or central point enhancement, 4 in low density and 8 in equal density. In the portal venous phase, 66 (71.74%) cancer foci were detected , 8 in high density, 58 in low density and 26 in equal density. In the delayed phase, 73 (79.35%) cancer foci were detected with low density, and other 19 in equal density. There were significant differences in the detection rate in the each phase (P<0.05). Conclusion Three-phase CT enhanced scan can show the enhanced features of hepatitis B cirrhosis-associated SHCC and help to improve the detection rate of SHCC.