OBJECTIVE: To evaluate the value of imaging examinations in the diagnosis of small kidney cancer. METHODS: Retrospective analysis of ultrasound, IVU, CT, MRI and other imaging data of 43 patients with surgically and pathologically confirmed small kidney cancer (≤3 cm in diameter). RESULTS: Among 43 cases of small kidney cancer, 28 cases were diagnosed as malignant tumor by ultrasound with a diagnostic accuracy of 65.1%, 29 cases were diagnosed by IVU and 7 cases had indirect signs (24.1%), 42 cases were diagnosed as malignant tumor by CT with a diagnostic accuracy of 97.7%, and 13 cases were diagnosed as malignant tumor by 14 MRI examinations with a diagnostic accuracy of 92.9%. Conclusion: CT and CT-enhanced scan in imaging examination have important values for qualitative and localized diagnosis of small kidney cancer.