Objective Contrast the liver benign and malignant tumors size values measured by gray scale ultrasound and contrast-enhanced ultrasound (CEUS). Explore the value of CEUS exam before liver cancer surgery. Methods Sixty cases of liver patients (60 lesions), checked by gray scale ultrasound and CEUS. Comparing the tumor shape, size which observed by different ways of ultrasound, the accurate of detection information and mechanism of CEUS used in the liver lesions treatment were analysis. Results Twenty nine cases of high echo lesions were liver hemangioma, 27 cases of hypoechoic lesions (22 cases of primary hepatocellular carcinoma, 5 cases of liver hemangioma) and 4 cases of hybrid echo lesions were primary hepatocellular carcinoma(HCC). The difference of the liver hemangioma sizes respectively observed by CEUS artery phase,venous phase, delayed phase and gray-scale ultrasound was not significant (P > 0.05).The size values of HCC measured in the arterial phase of CEUS were larger than other ultrasonic detection methods. It was significant difference (P <0.05). Conclusions CEUS can provide accurate and valuable reference for the HCC operative scheme selection, formulation and the removal range.