Abstract: Object: To investigate the MSCT signs, diagnosis and misdiagnosis causes of early central lung cancer in order to improve the MSCT diagnostic level of early central lung cancer. Methods: CT data of 29 cases of early central type lung cancer confirmed by pathology were analyzed and the main features, diagnosis and misdiagnosis factors of MSCT were analyzed. Results: CT diagnosis or diagnosis of central lung cancer in 24 cases, pneumonia in 1 case, bronchial dilatation with infection in 1 case, tuberculosis in 1 case, missed diagnosis in 2 cases, and analysis of the causes of misdiagnosis cases. In early stage, the main CT features of the central lung cancer include: the bronchial lumen, the thickening of the bronchial tube wall, the lumen of the stenosis, bronchial casts shadow, obstructive pneumonia and pulmonary stenosis, etc. Conclusion: Early central lung cancer with MSCT, multidimensional reconstruction and CI main signs to find the disease early and accurate diagnosis is of great significance, familiar with CT of bronchial anatomy structure, good read piece habits of observation, careful reconstruction is helpful to improve the diagnosis of early central lung cancer.