Objective To analyze the correlation of CT and pathological manifestation of small renal cell carcinoma (SRCC). Methods Thirty six SRCC were all diagnosed by surgical pathology. On CT, attenuation value and the amount of enhancement were observed; on pathology, tumor cell characteristics, cell arrangement, the stage and grade of the tumor et al were observed. Results 31 tumors were iso or hypoattenuation on CT and clear cell tumors were dominant in 28 cases; 5 cases were hyperattenuation and 2 of them were granular cell carcinoma. After the contrast enhancement, 31 tumors were enhanced more than 40 HU. 27 of them were solid which had abundant sinusoid vessels; Enhancement in 29 cases was heterogeneous, and on pathology, hemorrhage and necrosis were found in 27 of them. Conclusion The CT findings of SRCC were correlated with tumor cell characteristic and architecture.