Objective To evaluate the diagnostic value of three-dimensional multidetector-row computed tomogra-phy (MDCT) in detecting acquired renal arteriovenous malformation (RAVM) and to compare its perfor-mance with that of ultrasonography and digital subtraction angiography (DSA). Methods The institutional review board approved this retrospective study and written informed consent was obtained from al patients before examination. Al 14 patients with acquired RAVM underwent MDCT, including cortical and medul ary phase enhancement angiography and three-dimensional (3D) reconstruc-tion. Five and nine patients were further examined and their diagnoses confirmed by DSA and surgery, respectively. The MDCT images, including 3D reconstructions, were analyzed for RAVM independently and in consensus by two observers using a workstation. Results Among the 14 patients with acquired RAVM, 12 with maximum lesion diameter ≥ 10 mm, and one with a maximum lesion diameter between 5 and 10 mm, were correctly diagnosed with MDCT angiog-raphy. Among these patients, four diagnoses were confirmed by DSA. One patient with a lesion 5–10 mm in diameter was misdiagnosed with a renal aneurysm by MDCT angiography. The other one with the maxi-mum diameter of the lesion between 5 mm and 10 mm was misdiagnosed as renal aneurysm with MDCT angiography, which was diagnosed as renal arteriovenous malformation with DSA. Among 14 lesions in 14 patients, eight and six originated in the left and right kidney, respectively. Conclusion MDCT angiography can accurately diagnose RAVM and improve our understanding of the disease, which wil al ow clinicians to provide better care.