Objective To analyze clinical and chest thin-layer CT imaging characteristics of 20 coronavirus disease 2019(COVID-19) patients without fever. Methods Clinical characteristics of 20 COVID-19 patients without fever at the first admission in a hospital were retrospectively analyzed, including symptoms of respiratory tract and digestive tract, as well as laboratory test results of white blood cell count, lymphocyte count and C-reactive protein, meanwhile, the thin-layer CT scanning data of chest were analyzed. Results Clinical symptoms were classified into completely asymptomatic, respiratory or/and digestive symptoms without fever, symptoms of the latter were mild, mainly dry cough, leukopenia and lymphopenia was common in laboratory test results. Chest thin-layer CT in COVID-19 patients without fever mainly showed early and convalescent images, and a few showed progressive images:(1) In the early stage, segmental or multi-segmental ground-glass opacity (GGO) with patchy, nodular, or irregular form distributed along the peripheral of lung or subpleural area, among which vascular thickened and uneven length of linear high density opacity may be found in some patients; (2) In progressive stage, lesions enlarged as irregular form, and multiple pulmonary segments and lobes were involved, showing the "paving stone" sign or even evolved into pulmonary consolidation; (3) In convalescent stage, lesions diminished, completely absorbed, and residual fiber was uncommon. Conclusion Clinical characteristics of COVID-19 patients without fever are occult, while thin-layer CT findings of chest are typical, chest thin-layer CT plays an important role in the early diagnosis and evaluation of COVID-19.