Objective Analyze the characteristics of conventional ultrasound and contrast-enhanced ultrasound in adult testicular tumors and tumor-like lesions，and explore the value of contrast-enhanced ultrasound in their differential diagnosis. Methods Retrospectively analyze the conventional ultrasound and ultrasound imaging data of 40 patients with testicular tumors and tumor-like lesions confirmed by operation and pathology(26 cases in the testicular tumor group and 14 cases in the tumor-like lesion group)，compare the imaging characteristics of the two diseases，and analyze the diagnostic efficiency of contrast-enhanced ultrasound. Results Comparison of the size，morphology and echo uniformity of the testicular tumor group and tumor-like lesion group was statistically significant(all P＜0.05). There were statistically significant differences in enhancement intensity，enhancement shape，enhancement mode and "pseud-capsule" sign（all P＜0.05）. The sensitivity，specificity，and accuracy of conventional ultrasound in the diagnosis of testicular tumors were 88.5%，64.3%，and 80.0%. The sensitivity，specificity，and accuracy of contrast-enhanced ultrasound in the diagnosis of testicular tumors were 100%，92.9%and 97.5%. In conventional ultrasound and contrast-enhanced ultrasound，z = 1.835，P = 0.0665，there was no statistical difference between the two methods. Conclusion Combined with a variety of CEUS features，it is helpful for the differential diagnosis of different types of testicular tumors and tumor-like lesions.