Objective To evaluate the value of the three dynamic contrast-enhanced scan with spiral CT in hepatic tu-bercular lesion. Methods Retrospectively 38 cases with hepatic tubercular lesions less than 5cm were studied , which were performed with the three dynamic contrast-enhanced scan with spiral CT in our hospital from Jun. 2010 to Mar. 2014. Results Ten cases of hepatocellular carcinoma were characterized by lower density in the venous and delay phase, and obviously enhanced in the arterial phase. 7 cases of liver metastases were characterized by less enhanced in the arterial phase, loop in the venous phase, lower density in the delay phase. 8 cases of hemangioma were charac-terized by tubercular in the arterial phase , concentric enhanced in the venous phase , equidensity in the delay phase. 3 cases of inflammatory pseudo tumors were characterized by less enhanced in the arterial phase , concentric en-hanced in the venous phase and delay phase. 1 case of tuberculoma were characterized by slightly loop especially in the venous and delay phase. Not enhanced in the all the phase for 9 cases of cysts. Conclusion The imaging of three dynamic contrast-enhanced scan with spiral CT are characteristic in mostly hepatic tubercular lesion , and could pro-vide reference to qualitative diagnosis.