Objective: To explore the evaluation value of multi-slice spiral computed tomography (CT) for hypovolemic shock in patients with severe trauma. Methods:? A total of 70 patients with severe trauma and suspected shock in the hospital were enrolled between January 2022 and April 2025. According to presence or absence of hypovolemic shock, they were divided into shock group (32 cases) and non-shock group (38 cases). The general data, imaging signs and CT indexes (collapse rate of inferior vena cava, standard deviation of spleen CT value, CT value of mesenteric fat) in the two groups were compared. After correcting for the influence of general data, relationship between imaging signs, CT indexes and hypovolemic shock in patients with severe trauma was analyzed by Logistic regression analysis. Results:? There was no difference in collapse rate of inferior vena cava between the two groups (P>0.05), but standard deviation of spleen CT value in shock group was lower than that in non-shock group, and CT value of mesenteric fat was greater than that in non-shock group (P<0.05). After correcting for the influence of differential factors, the results of Logistic regression analysis showed that low standard deviation of spleen CT value and high CT value of mesenteric fat could be applied to predict hypovolume shock in patients with severe trauma (P<0.05). Conclusion:? Low standard deviation of spleen CT value and high CT value of mesenteric fat can predict hypovolemic shock in patients with severe trauma. Multi-slice spiral CT can improve predictive accuracy and provide basis for individualized resuscitation strategies.