Objective: To evaluate the diagnostic methods of primary malignant tumors of duodenum. Methods: A retrospective analysis was conducted based on the clinical data of 28 patients with primary malignant tumors of duodenum. Results: Sixteen patients underwent endoscopic examination, 15 of them were positive (93.75%) with the tumors located at upper duodenum and around the papillae. Thirteen patients underwent hypotonic duodenogram and 10 of them were positive (76.92% ), with the tumors located both at upper and lower duodenum. 28 patients underwent ultrasonography, with the positive rate of 53.57% (15/28),all of them being cholangiectasis. Conclusions: Endoscopy was the main method for the diagnosis of tumors located at upper part and around the papillae of the duodenum,and hypotonic duodenogram was effective in the diagnosis of tumors located at lower duodenum.