Objective To explore the diagnostic efficiency of DR and 64-slice spiral CT in nasal bone fracture. Methods Nasal DR and 64-slice spiral CT data of 77 patients with nasal trauma within 1-7d after trauma were analyzed and compared. Results Of 77 patients with CT diagnosis, 38 patients were diagnosed as line-like fractures of nasal bone, 31 patients as comminuted fractures, 8 patients as normal, and 25 patients had concurrent fracture of the other adjacent sites. Of 77 patients with DR diagnosis, 44 patients were diagnosed as fractures of nasal bone, 14 patients as suspected fractures, 19 patients has no fracture (including missed fracture of nasal bone in 13 patients and normal nasal bone in 6 patients), and no patient as concurrent fracture of the other adjacent sites. The correct rate of CT diagnosis of nasal bone fracture was 100%, however the correct rate and missed rate of DR diagnosis of nasal bone fracture were 63.8% and 18.8% respectively. The diagnotic correct rate between CT and DR was significantly different (P<0.05). Conclusion 64-slice spiral CT can correctly judge the existence of nasal bone fracture, and the site and type of the fracture. Multislice spiral CT could be preferred as conventional method for the diagnosis of nasal trauma under possible medical conditions.