Abstract: Objective To study the value of CT diagnosis in localized malignant peritoneal mesothelioma. Methods CT features of 4 cases with localized malignant peritoneal mesothelioma and the pathological basis were analyzed. Results All 4 cases showed a large localized mass with an average size of 13 cm. 3 of 4 cases were cystic-solid predominantly multi-cystic; another case was solid accompanied by necrosis. Contrast CT demonstrated marked enhancement in the solid portion of tumor in all 4 cases, the highest CT density was 106 HU(average 76 HU). There was no distant metastasis and ascites. Conclusion Multi-cysts, remarkable enhancement of the solid area and no distant metastasis may be the main characteristic CT features of localized malignant peritoneal mesothelioma.