Abstract: Objective To investigate the correlation between the severity of clinical symptoms and CT imaging features in patients with lumbar disc herniation. Methods Total 167 patients with lumbar disc herniation admitted to our hospital were selected as subjects, who were divided into mild (58 cases), moderate (64 cases) and severe (45 cases) according to the judgment results of the low back pain assessment scale. The correlation between severity of clinical symptoms and CT imaging features were analyzed. The correlation between the severity of clinical manifestations and the anteroposterior diameter and sagittal diameter of the dural sac was analyzed, and the correlation between the modified Japanese orthopaedic association score (mJOA) and the anterior and posterior diameter of the dural sac was analyzed by Pearson correlation analysis. Results There were significant differences in CT imaging features between patients with mild, moderate and severe lumbar disc herniation, such as pathological type of nucleus pulposus, nucleus pulposus shape, nucleus pulp density value, the degree of protrusion of the nucleus pulposu through the frontal plane, the degree of nucleus pulposus through the horizontal plane, the relationship between the nucleus pulposus and the nerve root, and the degree of compression of the dural sac after the nucleus pulposus (P<0.05). In the patients with mild, moderate and severe, the anteroposterior diameter of the dural sac increased sequentially (P<0.05), and the sagittal diameter decreased in turn (P<0.05). The correlation analysis of Pearson showed that the mJOA score was positively correlated with the anteroposterior diameter of the dural sac (r=0.584, P=0.017), and negatively correlated with the sagittal diameter of the dural sac (r=-0.603, P=0.025). Conclusion For most patients with lumbar disc herniation, the severity of clinical symptoms is correlated with some CT imaging features.