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Objective To investigate the value of CT enterography (CTE) in the diagnosis and differential diagnosis of small intestinal tumors and tumor-like lesions. Methods A retrospective analysis was performed for the imaging data of 74 patients who underwent CTE in our hospital from January 2015 to December 2022 and were diagnosed with small intestinal tumors and tumor-like lesions based on pathological examination, and according to the nature of lesions, they were divided into malignant tumor group with 54 patients and non-malignant+tumor-like lesion group with 20 patients. The two groups were compared in terms of major axis of tumor, intestinal residual rate, and CT values during plain scan phase, arterial phase, and venous phase. Results Compared with the non-malignant+tumor-like lesion group, the malignant tumor group had significantly higher major axis of tumor and CT value during plain scan phase (Z=-3.512,-3.214,P0.05). In the malignant tumor group, compared with the patients with adenocarcinoma, the patients with lymphoma had significantly higher major axis of tumor and intestinal residual rate (Z=-3.161,-4.853,P0.05). Conclusion CTE can fully display the features of small intestinal tumor and tumor-like lesions and thus provide a basis for the diagnosis and differential diagnosis of these diseases.