〔Abstract〕 Objective To analyze the computed tomography (CT) image features of pneumonia-type invasive lung adenocarcinoma (IMA) and its relationship with pathological features. Methods From March 2017 to February 2023, 70 case of patients with pneumonia-type invasive adenocarcinoma of the lung diagnosed and treated in a hospital were selected as the invasion group, and the other 70 cases of patients with pneumonia-type benign nodules diagnosed and treated in our hospital were selected as the nodule group at the same time. All patients were underwent multi-slice spiral CT examination and pathological examination, recorded the CT image features and pathological features, and determining diagnostic value. Results The CT detection rates of interlobar fissure swelling, air bronchogram, dry branch sign and angiographic sign in the infiltrating group were significantly higher than those in the nodule group, with statistical significance (P < 0.05). The pathological feature detection rates of depth of invasion (T3 ~ T4), lymph node metastasis and low tissue differentiation in the infiltrating group were significantly higher than those in the nodule group with statistical significance (P < 0.05). Pneumonia-type logistic regression showed that the risk factors of infiltration depth T3 ~ T4, lymph node metastasis, and low tissue differentiation in IMA patients were interlobal swelling, air bronchogram sign, dry branch sign, and angiographic sign (P < 0.05). Conclusion CT diagnosis of pneumonia-type IMA has significant features, often accompanied by increased CT values, and pathological manifestations include increased infiltration depth, lymph node metastasis, and low tissue differentiation. The risk factors for the infiltration depth of T3 ~ T4, lymph node metastasis and low tissue differentiation are interlobar swelling, air bronchogram sign, dry branch sign and angiographic sign in pneumonia-type IMA patients.