Objective To study the clinical value of contrast-enhanced ultrasound power doppler in differential diagnosis of focal nodular hyperplasia (FNH) and hepatocellular carcinoma (HCC) of the liver, and provide reference for clinical practice. Methods 80 patients with liver diseases admitted to the Second People’s Hospital of Neijiang from January 2020 to December 2021 were selected for retrospective analysis. They were divided into FNH group (38 cases) and HCC group (42 cases) according to the nature of the lesions. The quantitative parameters of contrast-enhanced ultrasound [time to peak (TTP), arrival time (AT), mean transit time (MTT) and enhancement slope (ES)] and imaging characteristics of the two groups were compared. The value of contrast-enhanced ultrasound power doppler in differentiating FNH from HCC were analyzed. Results The incidence of lymphadenopathy and cirrhosis in FNH group were lower than that in HCC group, and the incidence of central scar in FNH group was higher than that in HCC group (P<0.05). Iso-enhancement was dominant in FNH group at portal pulse stage, hypoenhancement was dominant in HCC group, and hypoenhancement was dominant in both delayed stage groups. (P<0.05). The ball sign and “wheel like” blood ?ow signal rate in FNH group were higher than those in HCC group, and TTP and AT were signi?cantly shorter than those in HCC group (all P<0.05). The results of ROC curve analysis showed that the “wheel like” blood ?ow signals [area under the curve (AUC) =0.716, sensitivity=0.574, speci?city=0.845, P=0.020], TTP (AUC=0.767, sensitivity=0.842, speci?city=0.714, P=0.004) and AT (AUC=0.717, sensitivity=0.789, speci?city=0.571, P=0.019) had certain application value in differentiating HCC and FNH. Conclusion Contrast-enhanced ultrasound power doppler examination is helpful in the differential diagnosis of HCC and FNH, among which “wheel like” blood ?ow signal, TTP and AT have higher diagnostic value.