Objective To analyze the diagnostic value of contrast-enhanced ultrasonography in differentiating renal cell carcinoma (RCC) subtype and angiomyolipoma (AML). Methods 76 patients with renal tumors, including 45 cases of clear cell carcinoma (CCRCC), 9 cases of papillary carcinoma (PRCC), 8 cases of chromophobe cell carcinoma (CHRCC) and 14 cases of AML, were retrospectively analyzed. The conventional ultrasound signs, CEUS enhancement patterns and the contrast parameter difference of time intensity curve (TIC) between the lesion and the surrounding normal renal parenchyma were compared and analyzed. Results ① Between RCC and AML groups, there were statistical differences in tumor internal echo height, internal echo uniformity, growth mode, false envelope, blood flow signal, contrast perfusion mode, regression mode, uniformity after enhancement, presence or absence of circular high enhancement, △PI, △BI and △TTP (all P < 0.05); ②The subtypes of AML and RCC were compared and analyzed. AML and CCRCC were easy to distinguish; There were significant differences between AML, PRCC and CHRCC groups in tumor internal echo, homogeneity after enhancement and △BI (P <0.05). Among different renal cancer subtypes, the proportion of slow regression, high enhancement and circular high enhancement in CCRCC group was higher than that in PRCC and CHRCC groups (P < 0.05), but there was no significant difference in contrast-enhanced characteristics between PRCC and CHRCC groups. Compared with PRCC and CHRCC groups, the △PI and △AUC of CCRCC group were larger ，the △BI of CCRCC group were smaller(P < 0.05), but there was no significant difference between CHRCC and PRCC groups. In addition, the △BI in CCRCC group were slightly lower than those in PRCC group (P < 0.05); The △Grad of CCRCC and CHRCC was higher than that of PRCC group, The △BI of CCRCC and CHRCC was lower than that of PRCC group (all P < 0.05). Conclusions Contrast enhanced mode and quantitative parameter analysis have certain application value in differentiating renal cell carcinoma subtype and AML, and can provide reference for clinical preoperative decision-making and prognosis evaluation.