OBJECTIVE: To analyze the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with magnetic resonance imaging (MRI) in primary hepatocellular carcinoma (HCC), and therefore to provide a theoretical basis for the clinical diagnosis of HCC. STUDY DESIGN: This study included a total of 100 HCC patients who were diagnosed and treated at The Affiliated Hospital of Putian University between January 2019 and January 2020. The baseline information of the patients, their complications, and their histopathological and imaging results were collected and recorded. The accuracy and detection rate of CEUS, MRI, and CEUS+MRI for HCC, as well as their specificity, sensitivity, positive predictive value, and negative predictive value, were further compared. RESULTS: The accuracy and detection rate of CEUS was slightly higher than those of CEUS or MRI alone, but there was no significant difference. Compared with the other 2 methods, CEUS+MRI had higher sensitivity and negative predictive value but lower specificity. CONCLUSION: CEUS combined with MRI reduces the specificity but improves the sensitivity in the diagnosis of HCC. This combination provides a new strategy for the effective diagnosis of HCC in clinical practice. (Anal Quant Cytopathol Histpathol 2021;43:833-840) © Science Printers and Publishers, Inc. © 2021 Science Printers and Publishers Inc.. All rights reserved.