Objective To explore the diagnostic value of Sonazoid contrast-enhanced ultrasound and gadoxetic acid-enhanced magnetic resonance imaging in hepatocellular carcinoma. Methods Retrospective analysis the patient data from June 2021 to December 2023 at our Hospital who underwent Sonazoid contrast-enhanced ultrasound and gadoxetic acid-enhanced magnetic resonance imaging for liver space occupying lesions. Analyzing the enhancement characteristics of liver space occupying lesions at different stages in two imaging examinations. Taking the surgical or puncture pathology results, or clinical follow-up results greater than 6 months as the "gold standard", calculating the accuracy, sensitivity, and specificity of Sonazoid contrast-enhanced ultrasound and gadoxetic acid-enhanced magnetic resonance imaging in the diagnosis of HCC respectively. And use Kappa test to verify its consistency. Results Taking the surgical or puncture pathology results, or clinical follow-up results greater than 6 months as the "gold standard", the accuracy, sensitivity, and specificity of Sonazoid contrast-enhanced ultrasound and gadoxetic acid-enhanced magnetic resonance imaging in diagnosing liver mass lesions as HCC were 87.27%, 90.24%, 78.57% and 90.91%, 92.68%, 85.71% respectively. There is no statistically significant difference between the two test, with a P-value greater than 0.05. The consistency test between Sonazoid contrast-enhanced ultrasound and gadoxetic acid-enhanced magnetic resonance imaging showed a Kappa value of 0.908, indicating good consistency. Conclusion The consistency test between Sonazoid contrast-enhanced ultrasound and gadoxetic acid-enhanced magnetic resonance imaging showed that there is no statistically significant difference between the two test, with a P-value greater than 0.05. The Kappa value is 0.908 which indicates good consistency. So as a new type of liver specific ultrasound diagnostic contrast agent, Sonazoid has a comparable clinical value in the diagnosis of liver space occupying lesions with gadoxetic acid-enhanced magnetic resonance imaging. It can be widely used in clinical practice as another reliable imaging examination for diagnosing focal liver lesions.