Computed tomography (CT) is one of the most commonly used examination methods in clinical practice, but its resolution for soft-tissue is not high enough, making it difficult to detect and identify some lesions, and it is insufficient in quantitative assessment. The advantages of spectral CT imaging are multi-parameter, multi-dimensional and quantitative imaging, which reflects the compositional characteristics of tissues and the characteristics of blood supply. It can simulate images of a single KeV energy, through two sets of high-energy and low-energy data, namely virtual monoenergetic images (VMI). In this review, the current problems in the use of VMI and iodine maps in lesion detection and differentiating diagnosis of abdominal diseases were concluded. The progress in detection of liver and pancreas lesion were pointed out. For example, the confidence level was raised from 52.4 to 68.8 in detection of small hepatocellular carcinoma by using VMI. In the pancreas, compared with normal CT, detection rate of VMI for endocrine tumor in pancreas was raised from 84.6% to 92.3%. What’s more, in terms of differential diagnosis, there have been many advances in the research on VMI and iodine density maps, and higher efficiency in differentiating diagnosis has been obtained in the classification of kidney cyst, differentiation between small hepatocellular carcinoma and small hepatic hemangioma, and differentiation of serous and mucinous cystadenoma in pancreas. Based on current progress, the future of VMI and iodine maps in abdominal diseases is prospected.