According to the pathological types, primary liver cancer is mainly divided into three common subtypes: hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma. Due to the difference in treatment and prognosis, the differential diagnosis of the three is very important. Contrast-enhanced ultrasound can realize real-time contrast imaging of tissue microvascular perfusion and has high potential in the diagnosis of primary liver cancer. Each type of liver cancer has its own characteristics, but there is still overlap in imaging features. In order to improve the accuracy of diagnosis of liver cancer, tumor markers are often analyzed. The application of some new methods is expected to contribute to the differential diagnosis of primary liver cancer subtypes by contrast-enhanced ultrasound.