Objective To evaluate the value of multi-slice computed tomography (MSCT) enhanced scanning combined with CT texture analysis in lymph node metastasis of rectal cancer. Methods 60 patients with rectal cancer admitted to our hospital from January 2022 to January 2024 were selected as the study objects. Lymph node metastasis was evaluated according to pathological findings. The patients were divided into metastatic and non-metastatic groups according to the presence or absence of lymph node metastasis. Both groups underwent MSCT examination. The imaging features and CT texture features of the two groups were analyzed and compared. Receiver operating characteristic (ROC) curve was drawn for analysis. Results Among 60 patients with rectal cancer, 38 cases did not have lymph node metastasis, accounting for 63.33%. Lymph node metastasis occurred in 22 cases (36.67%). After MSCT enhancement scan, the tumor short diameter, CTmax value and CT enhancement difference in the occurrence group were significantly higher than those in the non-occurrence group, and the number of patients with invasion ≥1/2 week length was significantly higher than that in the non-occurrence group (P < 0.05). In the CT texture parameters, the kurtosis, entropy and mean value of the occurrence group were significantly higher than those of the non-occurrence group (P < 0.05). The area under the curve (AUC) values of MSCT enhanced scanning features and CT texture parameters ranged from 0.693 to 0.961, sensitivity from 0.500 to 0.909, and specificity from 0.658 to 0.998. Conclusion MSCT imaging features have a certain value in predicting lymph node metastasis of rectal cancer, including lymph node short diameter, CT enhancement difference, etc., and combined with CT texture analysis can further improve the ability to predict the risk of lymph node metastasis of rectal cancer.