Objective: To evaluate the clinical value of CT multi-plane three-dimensional reconstruction in the diagnosis of lumbar disc herniation (LDH). Methods The clinical data of 112 LDH patients admitted to our hospital from January 2023 to June 2024 were retrospectively collected. All patients underwent CT examination on admission and were further examined by CT multiplane 3D reconstruction after CT examination. Taking the results of magnetic resonance imaging (MRI) as the gold standard for the diagnosis of LDH, the value of CT multi-plane 3D reconstruction in the diagnosis of LDH was analyzed. Results MRI diagnosis showed that among 112 LDH patients, 28 cases were central type, 35 cases were prolapse type, 33 cases were intervertebral foramen type and 16 cases were paracentral type. There were 17 cases of L2-L3, 40 cases of L3-L4, 43 cases of L4-L5 and 12 cases of L5-S1. The type of disc herniation detected by CT in LDH patients was generally consistent with that by MRI (Kappa=0.606, P < 0.001). The type of disc herniation detected by CT multiplane three-dimensional reconstruction was consistent with that by MRI (Kappa=0.939, P < 0.001). The consistency of disc herniation segments detected by CT multiplane three-dimensional reconstruction in LDH patients was stronger than that detected by MRI (Kappa=0.961, P < 0.001), and higher than that detected by CT in LDH patients with MRI results (Kappa=0.844, P < 0.001). The detection accuracy of CT multi-plane 3D reconstruction was 95.54% (107/112) for LDH, 95.54% (107/112) for LDH protrusion type, and 97.32% (109/112) for LDH protrusion segment, all of which were higher than those of CT, and the difference was statistically significant (P < 0.05). Conclusion CT multi-plane 3D reconstruction technique has good application value in the diagnosis of LDH, and can effectively evaluate the type and protrusion segment of patients with intervertebral disc herniation, and improve the detection accuracy.