To compare the diagnostic value of 3D-TOF-MRA and 3D-CE-MRA in carotid cavernous fistula(CCF). Methods: Twenty patients with CCF were enrolled. All patients underwent MRI, 3D-CE-MRA, and 3D-TOF-MRA examination. The visualization ratios of superior ophthalmic vein dilatation, sinus cavernosus, sinus intercavernosi, superior petrosal sinus dilatation, inferior petrosal sinus dilatation, and fistula of 3D-CE-MRA and 3D-TOF-MRA were compared in all patients. Results: Compared with 3D-TOF-MRA, the visualization ratios of sinus cavernosus, sinus intercavernosi, superior petrosal sinus dilatation, inferior petrosal sinus dilatation, and fistula of 3D-CE-MRA were increased (P<0.05). There was no significant difference between 3D-TOF-MRA and 3D-CE-MRA in the visualization ratios of superior ophthalmic vein dilatation (P>0.05). Conclusion: 3D-CE-MRA diagnosis of CCF is fast, non-invasive, and functionally simple. Compared to 3D-TOF-MRA, 3D-CE-MRA provides better imaging of cavernous sinus expansion and draining vein expansion as well as better fistula imaging