Objective To explore the application value of contrast C-arm CT technology in assisting adrenal venous sampling.Methods A retrospective analysis of patients diagnosed with Primary hyperaldosteronism (PA) and adrenal venous sampling (AVS) in our hospital from February 2020 to August 2021，Who were retrospectively divided into traditional group and experimental group. There were 17 cases in the traditional group and 21 cases in the experimental group. The operation procedure of the traditional group: the right adrenal vein was intubated，and the blood was collected after the catheter was confirmed in right adrenal vein by angiography. Then the left AVS was performed，and finally the blood was collected from the inferior vena cava. The AVS operation procedure of the experimental group: the right adrenal vein was intubated，if the angiography confirmed that the catheter might be in place，the angiographic C-arm CT scan further confirmed that the catheter was in place，then blood was collected. And procedure of left adrenal vein was same as traditional group. The success rate of adrenal venous sampling，and the amount of contrast agent，radiation dose，and operation time were compared between the two groups. Results There was no statistically significant difference in demographic baseline data between the two groups. In the traditional group，the AVS success rate of the right adrenal vein was 58.82%，and the AVS success rate of the left adrenal vein was 88.23%. The AVS success rate of the right adrenal vein in the experimental group was 95.24%，and the AVS success rate of the left adrenal vein was 100% in the experimental group. The difference in the AVS success rate of the right adrenal vein between the two groups was statistically significant，P<0.05，and the difference between the AVS success rates of the left adrenal vein of the two groups was not statistically significant，P>0.05. There was no statistically significant difference between the two groups in radiation dose，operation time，and contrast medium dosage，P>0.05. Conclusion Contrast C-arm CT technology can significantly improve the AVS success rate of the right adrenal vein without increasing the amount of contrast agent，radiation dose，and operation time. It has certain application value in AVS operations.