Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS) in liver metastases. Methods Thirty-six patients were examined with conventional ultrasonography, then underwent continuous real-time CEUS with low mechanical index. The size, location, number and perfusion patterns of liver metastases were evaluated. Results In 36 patients, 67 liver metastases were found with conventional ultrasound and 106 liver metastasis were found with CEUS. The perfusion patterns of lesions were in four types: ①Thirty-seven lesions (34.91%) showed as total enhancement during the early arterial phase and hypoechoic appearance during the portal venous phase and the late phase;②Fifty-six lesions (52.83%) showed a peripheral rim-like hyperechonic enhancement during the arterial phase and fast wash-out in the portal phase;③Twelve lesions (11.32%) showed as isoechoic enhancement during the arterial phase and the portal phase and was hypoechoic in the late phase;④One lesion (0.94%) showed hypoechoic appearance during all phases. The dimension of the lesions played an important role in the perfusion patterns. Conclusion The enhancement pattern and time of lesions are closely correlated with the tumor arterial supply. CEUS has high value in diagnosing liver metastases.