Abstract：Objective To compare the value of contrast-enhanced ultrasound (CEUS) with enhanced CT (CECT) in the diagnosis of benign and malignant renal tumors.Methods Qualified original research was conducted in the database of China Knowledge Network, Wanfang, PubMed and Embase, The Cochrane Library and other databases until December 2018. Two reviewers independently extracted relevant data and analyzed the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and summary recipients of CEUS and CECT, respectively, using Stata 14.0 software. Operating characteristics (SROC) curves and area under the curve (AUC), and explore the extent and potential sources of heterogeneity. The diagnostic value of CEUS and CECT for benign and malignant small renal tumors was further explored.Results A total of 10 controlled studies, 1290 lesions, and combined data of CEUS and CECT for renal tumors were included: sensitivity (Sen) was 0.95 (95% confidence interval [CI], 0.93-0.96) and 0.90 ( 95% confidence interval [CI], 0.85-0.93), specificity (Spe) was 0.75 (95% CI, 0.66-0.83) and 0.72 (95% CI, 0.63-0.80), and the diagnostic odds ratio (DOR) was 59 ( 95% CI, 35-100) and 27 (95% CI, 19-40), the area under the SROC curve were 0.95 (95% CI, 0.93-0.97) and 0.89 (95% CI, 0.86-0.91), respectively. In small renal tumors (tumor diameter <4 cm), CEUS showed higher sensitivity (0.95 vs. 0.87), while CEUS and CECT were quite specific (0.76 vs. 0.76).Conclusion CEUS has high sensitivity and moderate specificity in the diagnosis of renal tumors. The sensitivity of CEUS is higher in the diagnosis of small renal tumors, indicating that CEUS can be used as CECT in the differential diagnosis of renal tumors. The alternative method is to promote and study in the clinic.