Objective To explore the early diagnostic value of enhanced computed tomography (CT) multi-phase scanning for small Hepatocellular carcinoma (SHCC) in the context of cirrhosis. Methods A retrospective collection of data was conducted on 80 patients diagnosed with liver cirrhosis in Jiyuan Health School (Affiliated Hospital of Jiyuan Vocational and Technical College) from June 2021 to June 2025. Enhanced CT multi-phase examination was performed upon admission. Based on the pathological biopsy results of patients, the diagnostic value of multi-phase enhanced CT examination for SHCC was analyzed. And according to the occurrence of microvascular invasion (MVI) in patients, they were divided into an occurrence group and a non occurrence group, and the diagnostic efficacy of enhanced CT multi-phase scanning for MVI in SHCC patients was analyzed. Results The enhanced CT multi-phase scanning demonstrated a sensitivity of 89.19% (33/37), specificity of 93.02% (40/43), accuracy of 91.25% (73/80), positive predictive value of 91.67% (33/36), and negative predictive value of 90.91% (40/44) in diagnosing SHCC. The consistency between the results of multi-phase enhanced CT scans in diagnosing SHCC in the context of liver cirrhosis and pathological biopsy results was good (Kappa＝ 0.824, P＜0.001). Eight patients were diagnosed with MVI, with a positive rate of 21.62% (8/37). The proportion of increased blood supply vessels and solid density around the tumor in the occurrence group was higher than that in the non occurrence group (P＜0.05). The combination of blood supply vessels around the tumor and solid density around the lesion had strong diagnostic value for MVI in SHCC patients, with an area under the curve (AUC) value of 0.834. Conclusion Enhanced CT multi-phase scanning has high diagnostic value for early diagnosis of SHCC in the context of liver cirrhosis. The presence of blood supply vessels and increased density of tumor surrounding parenchyma have a certain value for assessing the occurrence of MVI in SHCC patients.