Objective To analyze the occurrence of pulmonary metastases and the diagnostic value of multislice spiral CT (MSCT). Methods A total of 62 patients with pulmonary metastases which examined by MSCT during the period from July 2015 to August 2017 were selected as the subjects. The types of primary lesions, types of metastases and MSCT image features, such as the edge, shape and internal structure of lesions were analyzed. The diagnostic efficiency of MSCT was evaluated with pathological findings as the golden standard. Results Among the 62 patients, 60 cases with lung metastases and 2 cases with benign lesions were confirmed by pathology. The types of primary tumors were digestive system in 31 cases (51.67%), respiratory system malignant tumors in 13 cases, malignant breast tumors in 10 cases (16.67%) and the other 6 cases (10.00%). Types of metastases included diffuse metastases in 20 cases (33.33%), multiple metastases in 33 cases (55.00%) and single metastasis in 7 cases (11.67%). MSCT examination showed that there were lobulated signs in 25 cases (40.32%), spicule signs in 13 cases (20.97%), halo signs in 2 cases (3.23%), calcification in 4 cases (6.45%) and bronchial signs in 6 cases (9.68%).The sensitivity and accuracy of MSCT enhanced scan in diagnosing pulmonary metastases were significantly higher than those of MSCT plain scan (P<0.05), but there was no statistically significant difference of specificity (P>0.05). Conclusion Pulmonary metastases mainly occur in digestive system, respiratory system and other malignant tumors, and multiple metastases are more common. Image features of MSCT scan are characteristic, and the diagnostic efficiency of MSCT enhanced scan is high.