Purpose: To evaluate the benefit of contrast-enhanced ultrasound compared to colour Doppler ultrasound in distinction between benign and malignant lymph nodes in pacients with peripheral lymphadenopathy. Methods and materials: Total number of 80 patients were examined (29 women, 51 men, age 22-86 years). Examinations were performed on Philips iU22 ultrasound machine using 17MHz probe natively for evaluation of pattern of node’s vascularization and 9MHz probe for evaluation of pattern of enhancement with 1,5 ml intravenous bolus of sulphur hexafluoride contrast agent (SonoVue, Bracco, Italy) using power modulation mode with mechanical index 0.04. According to the pattern of vascularization and enhancement the nodes were divided into group of benign and malignant ones. All nodes were extirpated, ultrasound and histological findings were correlated. Results: Total number of 84 lymph nodes were extirpated, 26 benign (30,9%) and 58 malignant (69,1%). Except for 4 nodes (4,8%) with hyperechoic center all nodes were hypoechoic. 8 nodes (9,5%) had no Doppler signal. According to ROC analysis senzitivity in comparison with native ultrasound examination increased from 77,6% to 98,3%, but specificity decreased from 84,6% to 80,4%. Overall accuracy of the method increased from 76,9% to 89,5%. Mann-Whitney U test confirmed larger maximum size of malignant nodes (p=0,024) and lower LT ratio (p<0,001). Metastasis and lymphoproliferative disorded could have been distinguished in case of malignant lymphadenopathy Conclusion: Contrast-enhanced ultrasound can detect changes in normal structure of a lymph node. Signs of malignancy are heterogeneous enhancement with peripheral rim, unenhancing center, areas of necrosis and postcontrast wash-out.