Neuron-specific enolase 20.93ng/mL is a mild elevation, which cannot be clearly identified as a tumor, and needs to be combined with the patient’s symptoms to improve the diagnosis of imaging and histological examination. The normal reference range of neuron-specific enolase is 0.00～16.3ng/mL, and neuron-specific enolase 20.93ng/mL is mildly elevated. Diseases such as small cell lung cancer, medullary thyroid carcinoma, melanoma, and retinoblastoma may cause elevated neuron-specific enolase, but neoplastic diseases are accompanied by other symptoms and require histologic examination to confirm the diagnosis. In addition, neuron-specific enolase is less specific and may be elevated in many non-neoplastic diseases, such as encephalitis, cerebral ischemia, and cerebral infarction. Neuron-specific enolase 20.93ng/mL should be taken seriously and prompt medical attention should be paid to improve the diagnosis by imaging examination.