Objective To explore the potential value of contrast-enhanced ultrasonography (CEUS) in diagnosis of renal pelvic carcinoma. Methods The ultrasonogram of conventional ultrasound and CEUS were analyzed retrospectively in 22 patients of renal pelvic carcinoma proved pathologically. The size, echo, boundary and color flow signal of renal pelvic lesions were observed with conventional ultrasound. The enhancement modality and phase of tumors were also observed with CEUS, including wash-in and wash-out time, as well as the perfusion appearances. Results The maximum diameters ranged from 1.5 cm to 8.5 cm in 22 renal pelvic tumors. Conventional ultrasound detected flat mass in 7 tumors, irregular mass in 15 tumors; the same side hydronephrosis in 11 patients. Color Doppler flow imaging (CDFI) disclosed fairly rich flow signal of 5 tumors, a small amount of flow signal around tumor in 9 tumors and no-flow signal in the rest tumors. CEUS detected the cortical phase enhancement in all renal pelvic tumors, including synchronously enhancement in 8 tumors and delayed enhancement in 14 tumors. In peak time, hypoechogenicity compared to the normal renal cortex was showed in 18 tumors, hyperechogenicity in 3 tumors and isoechogenicity in 1 tumor. Fast wash-out in medulla phase was displayed in 20 tumors, isochronously wash-out in 1 tumor and delayed wash-out in 1 tumor. The diagnostic accuracy of the conventional ultrasound and CEUS was 63.64% (14/22) and 81.82% (18/22), respectively. Conclusion CEUS can depict blood flow supply and improve the diagnostic rate of renal pelvic carcinoma.