Objective To explore the clinical value of CT for guiding interventional therapy of Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) obstruction.Methods A total of 329 consecutive BCS patients with IVC obstruction underwent endovascular treatment.All the patients underwent CT examination prior to endovascular treatment,and the data were retrospectively reviewed.The accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of CT were compared with results of DSA.Results DSA showed partial obstructive IVC in 108 BCS patients and complete obstructive IVC in 221 patients.CT demonstrated partially obstructive IVC in 99 patients and completely obstructive IVC in 230 patients.CT revealed 15 false-negative and 6 false-positive results.CT diagnosis of puncture or not yielded an accuracy of 94.19％,sensitivity of 97.29％,specificity of 86.11％,PPV of 93.49％ and NPV of 93.94 ％ for detection of BCS with partial IVC obstruction,while CT-based interventional treatment plan yield an accuracy of 97.55 ％,sensitivity of 100 ％,specificity of 92.52 ％,PPV of 96.49 ％ and NPVof 100％.Conclusion CT can provide high diagnostic accuracy and sensitivity for BCS patients with obstructed IVC,therefore being helpful to planning interventional treatment of BCS.