Abstract: Objective: To study the application value of analysis in distinguishing different pathological types of lung cancer by gemstone spectral imaging. Methods: Retrospective analysis of 106 patients with lung cancer (including small cell lung cancer, lung adenocarcinoma, lung squamous cell carcinoma, large cell lung cancer) confirmed by pathology. The gemstone spectral imaging data were analyzed. Results: The NIC and Calcium content, water content, effectiv-Z, slope rate of spectral curv of squamous carcinoma group and adenocarcinoma group, small cell carcinoma group, large cell lung cancer were0.07 ±0.03, 0.12±0.06, 0.05±0.03, 0.05±0.02, 9.59 ±5.29, 5.83 ±3.84, 2.65±1.47, 4.08 ±1.55, 1060.63 ±34.87, 1038.56 ±28.36, 1040.88 ±17.83, 1036.84 ±8.26, 7.87±0.27, 8.01 ±0.31, 7.73 ±0.32, 7.90 ±0.46, 0.77 ±0.49, 1.28 ±0.68, 0.29 ±0.14, 0.44 ±0.28 (P < 0.05). As for the result of LSD-t, There was statistically significant of NIC in each groups (P < 0.05); There was statistically significant of water content in squamous carcinoma group and adenocarcinoma group, small cell carcinoma group, large cell lung cancer (P < 0.05); There was statistically significant of Calcium content in not only squamous carcinoma group and adenocarcinoma group, small cell carcinoma group, large ceil lung cancer group, but adenocarcinoma group and small cell carcinoma group (P < 0.05); There was statistically significant of Effective-Z in not only squamous carcinoma group and adenocarcinoma group, but adenocarcinoma group and small cell carcinoma group (P < 0.05); There was statistically significant of slope rate of spectral curv in not only squamous carcinoma group and adenocarcinoma group, small cell carcinoma group, but adenocarcinoma group and small cell carcinoma group and large cell carcinoma group (P < 0.05). Conclusion: Spectral CT imaging has certain clinical significance in diagnosing different pathological types of lung cancer.