Objective To explore the application value of energy spectral computed tomography(CT)in the differential diagnosis of benign and malignant ovarian tumors,and analyze its CT indicators.Methods A total of 85 cases of ovarian tumors patients received in Heze Municipal Hospital from January 2020 to January 2022 were selected.All patients underwent histopathological examination and energy spectral CT.The application value of energy spectral CT in differential diagnosis of benign and malignant ovarian tumors was analyzed using the histopathological examination results as the gold standard.Results With histopathological examination results as the gold standard,malignant tumors were detected in 27 of 85 cases.58 patients with benign lesions;The accuracy,sensitivity and specificity of energy spectral CT in differential diagnosis of benign and malignant ovarian cancer patients were 91.76%,88.89%and 93.10%.Kappa analysis showed excellent consistency in differential diagnosis of ovarian cancer patients with energy spectral CT(Kappa=0.812).The slope of spectral curve(K)value,iodine concentration(IC)value and normalized iodine concentration(NIC)value of malignant ovarian cancer patients were lower than those of benign patients(P<0.05).Conclusion Energy spectral CT has good value for the differential diagnosis of benign and malignant ovarian tumors,and clinical differential diagnosis can be based on CT indicators.