AIM:To explore the image presentation and values of orbital color Doppler ultrasound imaging examination in the diagnosis of carotid cavemous fistula(CCF).METHODS:The imaging examination of 39 cases of CCF were retrospectively evaluated.RESULTS:All of 39 cases showed obvious dilated superior ophthalmic vein with artery blood flow model.Dilatation of the inferior ophthalmic vein in 3 cases,and 2 cases showed hypertraphled extraocular muscles.When common carotid artery in affected side were compressed,the internal carotid artery in affected side could present more or less reverse-perfusive blood flow.CONCLUSION:The orbital color Doppler ultrasound imaging examination can showed orbital internal enlarged blood vessel in CCF and its blood flow signal characters.It is valuable to diagnosis of CCF.