ObjectiveTo discuss multislice spiral CT (MSCT) features and pathologic basis of the cavernous hemangioma of mediastinum, and further improve the diagnostic accuracy with CT. MethodsWe collected 4 cases of cavernous hemangioma in mediastinum from November 2008 to November 2013. All patients underwent MSCT examination of plain scan and enhanced-contrast scan. The CT manifestations of cavernous hemangioma in mediastinum were observed. The correlation of the CT imaging findings with pathology features was analyzed retrospectively. ResultsTwo of the 4 lesions were located in the anterior mediastinum and the other 2 in the posterior mediastinum. On plain scan, 2 lesions showed homogeneous density, and 2 had heterogeneous density. Vessels could be observed in all lesions on enhanced-contrast CT imaging. ConclusionCavernous hemangioma in mediastinum is often located in the anterior and posterior mediastinum. Calcification and vessels in lesions are its imaging characteristics. Multislice spiral enhanced CT can accurately reflect the characteristics and pathological basis, providing more important information for diagnosis.