Objective: To investigate the value of CT spectral imaging in the study of carotid body tumors (CBT). Methods: Thirty patients with CBT who underwent CT energy spectrum examination and were confirmed by operation were included. Subsequently, 60 keV and 40 keV single energy images were reconstructed through the GSI viewer. The CT value, background noise (SD), contrast noise ratio (CNR), signal-to-noise ratio (SNR), and subjective score of CBT feeding arteries of the 40 keV, 60 keV single energy images and 120 kVp like images were statistically analyzed to evaluate the relationship between CBT energy spectrum parameters and imaging features with surgical results. Results: There was no correlation between energy spectrum parameters in the arterial and venous phases of CBT and the surgical results. However, CBT transverse diameter, longitudinal diameter, and Shamblin classification were strongly correlated with intraoperative bleeding, and the number of feeding arteries was moderately correlated with intraoperative bleeding. Additionally, the transverse diameter, longitudinal diameter, and Shamblin classification were moderately correlated with cranial nerve injury, and the number of feeding arteries was strongly correlated with cranial nerve injury. We also found that 40 keV was the best energy level for the CBT feeding artery display. Furthermore, the CT value, SD, CNR, and SNR of the 60 keV group were significantly higher than those of the 60 keV and 120 kVp like groups, and the CT value and noise of the 60 keV group were significantly higher than those of the 120 kVp like group. However, there was no significant difference in CNR and SNR between the two groups. The subjective evaluation score of the 40 keV group was the highest, and the subjective evaluation of the two radiologists had good consistency. Conclusion: (1) There was no correlation between the energy spectrum parameters in the arterial and venous phases of CBT and GAPP score. (2) The number of CBT feeding arteries is one of the important parameters for evaluating surgical complications and 40 keV single energy imaging can significantly optimize the display of CBT feeding arteries.