【Abstract】 Objective To analyze the CT features, clinical diagnostic value, and the causes of misdiagnosis for xanthogranulomatous cholecytitis (XGC) and improve its diagnostic accuracy.Methods The CT features of 20 patients of XGC confirmed by operation and pathology were retrospectively analyzed, and the imaging features of XGC were analyzed. Abdomen CT scans with and without contrast enhancement were performed in all patients.Results Only 4 cases was correctly diagnosed before surgery in all patients. CT features of XGC were included gallbladder enlargement in varying degrees (4 cases), gallbladder shrinking (9 cases) and gallbladder wall thickening (20 cases) by CT common scan. CT enhanced scan findings included hypodense nodules in the thickened walls (7 cases), continuous mucosal line (12 cases), fuzzy gallbladder and liver (4 cases), local infiltration of liver (4 cases), and “hypodense band” sign (4 cases). 12 patients were complicated with calculus of gallbladder. 1 patient was complicated with calculus of common bile duct. Conclusion The relevant imaging features of XGC can be found by CT scans. After contrast administration, hypoattenuated areas presented in thickened gallbladder wall, “hypodense band” sign, and continuous mucosal line on contrastenhanced CT are very important for the diagnosis and differential diagnosis of XGC.