Abstract: Objective: To investigate the value of CT and MRI in diagnosis and differential diagnosis of fat-containing primary hepatic carcinoma. Method: CT and MR imaging features of twenty-two patients with pathologically confirmed fat-containing primary hepatic carcinoma were retrospectively analyzed. Result: In 22 cases with fat-containing primary hepatic carcinoma,16 cases showed a giant mass, 4 cases were nodular type , and 2 cases were diffuse type. Of 22 cases, there were 17 cases of single lesion and 5 cases of multiple lesions. 1 lesion with fatty tissue can be discovered in every case of multiple lesions. 18 cases appeared as mainly solid masses, and fat was scattered with a small cluster distribution within the masses; 4 cases appeared as mainly fat masses and less solid components, and intratumoral fat showed a spherical performance. CT can show patchy and globular fat density within the lesions, MRI with fat suppression and chemical shift imaging of gradient echo sequence can identify the presence of fat. All 22 cases showed "fast in, fast out" enhancement features on dynamic contrast-enhanced imaging, and pseudocapsule was observed in 15 cases. Conclusion: CT and MRI can well demonstrate the imaging features of primary hepatic carcinoma and the adipose tissue within the tumor, which is valuable for diagnosis and differentiation.