Objective: To summary the appearances on contrast-enhanced ultrasonography of solitary necrotic nodules (SNN) of the liver, analyze the reasons of misdiagnosed cases, and improve the understanding of the disease. Methods: The contrast-enhanced ultrasonography and clinical data of 68 patients diagnosed SNN by contrast-enhanced ultrasonography or pathology were analyzed retrospectively. The diagnostic efficacy of contrast-enhanced ultrasonography in the diagnosis of SNN was evaluated and the reasons of misdiagnosis were analyzed. Results: In the 68 patients, 66 cases were confirmed as SNN by pathology or follow-up, 2 cases were confirmed hepatocellular carcinoma by pathology. On contrast-enhanced ultrasonography, 65 cases were correctly diagnosed as SNN, 2 cases were misdiagnosed as SNN, and 1 case was misdiagnosed as metastatic carcinoma. The diagnostic accordance rate of contrast-enhanced ultrasonography was 95.59% (65/68). The typical contrast-enhanced ultrasonographic appearances of SNN were as follows: there was no enhancement in the whole three-phase of the lesions, with or without peripheral thin rim-like and internal septum-like enhancement and without contrast agent decreasing in portal phase nor delayed phase. Conclusion: SNN has typical contrast-enhanced ultrasonography appearances with high diagnostic efficiency, which is worthy of clinical application.