Objective To explore the value of multi-slice spiral CT (MSCT) three-dimensional reconstruction image for diagnosis of limb joint fractures. Methods Sixty-four patients who were dubious of limb joint fractures on X-ray film were examined with multiplanar reconstruction (MPR), superficial shadow display (SSD) and volume rendering technique(VRT) in work station. Results MSCT MPR, SSD and VRT imaging clearly showed limb joints with different degrees of fractures in the 64 cases, the shape and course of fracture lines, the size of bone fragments and fragment displacement. Conclusions MSCT MPR, SSD and VRT can make accurate image diagnosis for occult fractures of limb joints, and provide detailed image information for making clinical treatment measures.