The role of computed tomography (CT) in the detection, evaluation, and management of paravertebral masses was studied in 32 consecutive patients with such lesions. The characteristics of the patients and masses were tabulated, and follow-up data were collected. There were 25 neoplasms (of which 24 were malignant), 5 inflammatory lesions, and two cases without proven diagnosis. The CT provided unique diagnostic information in 9 of the 32 cases (28%), and information that affected patient management in 13 cases (41%). Overall, CT proved of benefit in 19 of the 32 patients (59%). These findings indicate that CT can make important contributions to the diagnosis and management of paravertebral masses.