Objective To explore the effect of multilayer spiral CT on benign and malignant ovarian cystic gland tumors. Methods A total of 60 patients with ovarian sac gland tumors treated in Shanghai geriatrics from May 2023 to May 2024 were selected to participate in this study. After CT diagnosis and MR diagnosis of the patients, pathological examination was performed and the examination results were analyzed. Results Pathological examination found that among the 60 patients with ovarian cystic gland tumor, 20 patients had mucinous adenocarcinoma, 25 patients had serous cystic adenocarcinoma, 11 patients with endometrioma, and 1 patient each had granulosa cell tumor, clear cell tumor, metastatic tumor, and fibroma. Pathological examination found that among the 60 patients with ovarian cystic gland tumor, 20 patients had mucinous adenocarcinoma, 25 patients had serous cystic adenocarcinoma, 11 patients with endometrioma, and 1 patient each had granulosa cell tumor, clear cell tumor, metastatic tumor, and fibroma. The diagnostic accuracy of MRI was 81.67% (49/60), higher than that of CT 55.00% (33/60) (P<0.05). 60 cases of ovarian cystadenocarcinoma, 6 cases of stage I, 9 cases of stage II, 20 cases of stage III, 25 cases of stage IV. The coincidence rate of MRI staging was 66.67% (40/60), which was higher than that of CT 91.67% (55/60) (P<0.05). Malignant group, uneven enhanced density, and ascites were higher than the benign group, and the index difference was statistically significant (P<0.05) Malignant tumor diameter and CT value were higher than the benign group (P<0.05). Malignant group, uneven enhanced density, and ascites were higher than the benign group (P<0.05). Conclusions Multilayer spiral CT technology has good value in the differential diagnosis of benign and malignant ovarian cystic gland tumors, which can significantly improve the diagnostic efficiency of ovarian cystic gland tumors.