Abstract: Objective To improve the diagnostic accuracy of parapharyngeal space tumor by analyzing the imaging features of 48 cases in our hospital, and further guide the choice of treatment plan and surgical approach. Methods Total 48 patients with parapharyngeal space tumor were diagnosed by pathology in Department of Imaging and Otorhinolaryngology and Head and Neck Surgery from January 2016 to April 2020. Preoperative CT examination was performed in 36 patients(8 alone, 28 CT and MRI), and MRI in 40 patients(12 alone, 28 CT and MRI). According to the characteristics of imaging, the source of tumor was identified, and its nature was judged according to the characteristics of tumor imaging, and the coincidence rate with postoperative gross pathology was counted. Results CT and MRI examination could help to judge the source, location, size, boundary and relationship with the important anatomical structures around the tumor. The coincidence rate of CT combined with MRI was higher than that of CT alone(χ²=7.365, P=0.007), and the coincidence rate of CT combined with MRI was higher than that of MRI alone(χ²=6.160, P=0.013). Conclusion CT or(and) MRI examination can preliminarily identify the nature, location and source of the tumor. CT combined MRI examination of parapharyngeal space tumor is more important than the application of CT or MRI alone examination. Imaging, as a non-invasive examination, plays an important role in the diagnosis and differential diagnosis of parapharyngeal tumors, and has clinical guiding value in the selection of treatment plan and surgical approach.