Abstract: Objective To discuss the value of Image post-processing techniques of 64-slice CT in the diagnosis of external cardiac malformations.Materials and methods Retrospective reviews of imaging data base were done which consisted of 59 patients with congenital cardiovascular malformations who presented to our hospital. The scanning data were carried on multiple planar reformation (MPR), maximum intensity projection (MIP) and volume rendering (VR) as needed. The operation results were taken as diagnostic standard to evaluate the diagnostic accuracy of 64-slice spiral CT. Results 69 external cardiac malformations (cardiovascular connection department and peripheral vascular malformations) were confirmed by operation in all 59 patients. 67 malformations correctly diagnosed and 2 malformations were incorrecty diagnos in 64-slice spiral CT. The accuracy in diagnosing cardiovascular connection department and peripheral vascular malformations were 97.10% (67/69). There was no significant difference in image scores compared with the three image post-processing techniques (P value were 0.612, 0.902 and 0.815, respectively). Conclusions 64-slice spiral CT may be used as a primary technique and as a substitute for the diagnosis imaging portion of cardiovascular connection and peripheral vascular malformations