Abstract: Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in atypical metastatic liver tumors.Methods Fivty-nine patients with atypical metastatic liver tumors were studied both by conventional techniques and CEUS.The enhancement of echogenicity was evaluated.The diagnosis obtained by means of surgical biopsy.Results After CEUS, the number of flow lesions was significantly more than before CEUS(P＜0.05).The enhancement types of metastatic liver tumors were various, scarcing specificity compared with pathologic cell types of the primary tumors.The true diagnosis in CEUS and conventional ultrasound were 83% and 37% retrospectively.The increase in correct diagnosis was significiant(P＜0.05)when conventional ultrasound was tested against CEUS.The size and number of the lesions increased on CEUS compared with conventional ultrasound.Conclusions CEUS plays an important role in dignosis of atypical metastatic liver tumors.