Objective To investigate the value of ultrasound and multi-slice spiral CT in the differential diagnosis of renal eosinophilic adenoma and chromophobe cell carcinoma. Methods The clinical data of 45 cases of chromophobe cell carcinoma and 30 cases of renal eosinophilic adenoma confirmed by surgery and pathology were retrospectively analyzed. The study period was from February 2017 to October 2020. Both ultrasound and multi-slice spiral CT were performed. Compare the CT signs of renal eosinophilic adenoma and chromophobe cell carcinoma, observe the LKR value, △AT, △TTP, △PI of the plain scan, cortical phase, parenchymal phase, and excretion phase, and analyze the LKR value of each phase, ROC curve of △AT, △TTP, △PI, combined diagnosis. Results Routine ultrasound findings: renal eosinophilic adenoma and chromophobe cell carcinoma had no significant difference in the nature, echo, morphology and boundary of the lesion (P>0.05).Contrast-enhanced ultrasound findings: There was no statistically significant difference between renal eosinophil adenoma and chromophobe cell carcinoma in the enhancement mode and the decrease mode (P>0.05);Renal eosinophilic adenoma and chromophobe cell carcinoma had statistical significance in peak intensity, enhancement uniformity, pseudocapsule, △AT, △TTP, and △PI (P＜0.05).CT analysis showed that renal eosinophilic adenoma and chromophobe cell carcinoma were statistically significant in the comparison of star-shaped scars and uniform enhancement (P＜0.05); renal eosinophilic adenoma and chromophobe cell carcinoma were in cystic change There was no statistically significant difference in the proportions of, necrosis, calcification, capsule, spoke-like enhancement, segmental enhancement reversal, and bleeding (P>0.05).There was no significant difference in the LKR values of renal eosinophil adenoma and renal chromophobe cell carcinoma (P>0.05); the LKR values of renal eosinophil adenoma in cortical, parenchymal and excretory phases were higher than those in renal chromophobe cell carcinoma Chromophobe cell carcinoma (all P＜0.05).ROC curve analysis showed that the LKR AUC values of plain scan, cortical phase, parenchymal phase, and excretion phase in multi-slice spiral CT were (0.525, 0.931, 0.800, 0.850, P<0.05); △AT, △TTP, △PI The AUC values were (0.990, 0.673, 0.909, P<0.05); the AUC value of the combined diagnosis was (0.955, P<0.05). Conclusion Both ultrasound and multi-slice spiral CT have high predictive value in the diagnosis of chromophobe cell carcinoma, especially contrast-enhanced ultrasound, which can provide important information for the differentiation of renal eosinophilic adenoma and chromophobe cell carcinoma, but in order to avoid missed diagnosis If it occurs, it is recommended that the above two methods be combined clinically for diagnosis.