Objective To explore the contrast-enhanced ultrasound (CEUS) manifestations of hepatic capsular tuberculosis lesions and compare it with contrast-enhanced computer tomography (CT) and pathology. Methods 25 hepatic capsular tuberculosis were retrospectively analyzed, all have been done CEUS and enhancement CT. The CEUS manifestations of the hepatic capsular continuity, the presence and shape of the necrosis area, the enhancement of liver parenchyma around the lesion were observed and compared with enhanced CT and pathology. Results The lesions were divided into 4 groups including group 1 with one solid lesion, group 2 with 5 thin wall cavitary lesions, group 3 with 8 thick wall cavitary lesions and group 4 with 11 worm eroded cavitary lesions. The proportion of capsular continuity in group 1 and 2 was significantly higher than group 3 and 4 (P < 0.05); the percentage of the enhancement of liver parenchyma around the lesion in group 4 was significantly higher than that in the other groups (P < 0.05). The walls of the three types of cavitary lesions had different pathological composition. The CEUS manifestations of the hepatic capsular continuity, the enhancement of liver parenchyma around the lesion were consistent with enhanced CT. Conclusion Hepatic capsular tuberculosis lesions always accompanied with necrosis, CEUS is a promising method to evaluate the progress of Hepatic capsular tuberculosis lesions and provide important imaging information for clinical diagnosis and treatment.