Abstract: This study aimed to use multiphase-enhanced CT to evaluate the classification details of the Bosniak classification version 2019 of renal cystic lesions. A total of 88 cases of renal cystic lesions were enrolled. Two reviewers evaluated the details of the Bosniak v. 2019 classification and then compared the final classifications with pathological results. We found that the two reviewers had excellent consistency in evaluating the size, degree of homogeneity within the lesion, CT values of each scanning phase, number of septations, and nodule size of renal cystic lesions, while the consistency in evaluating the thickness of the cyst wall was good. The consistency in evaluating lesion septal thickness and irregular protrusion thickness was moderate. Compared to pathological results, we found that for benign and malignant renal cystic lesions, there were statistical significance in lesion size, homogeneity, CT values of each scanning phase, cyst wall thickness, septal thickness, and number of septations, while there was no significant statistical significance in calcification size. Therefore, the evaluation of the classification details of Bosniak classification v. 2019 CT is beneficial in determining the benign and malignant nature of renal cystic lesions, but there are differences in observer consistency.