The accurate diagnosis of liver tumours is essential for effective treatment. This study is aimed at comparing the diagnostic accuracy of conventional ultrasound (US) and contrast enhanced ultrasound (CEUS) for detecting and characterizing liver tumours. There is still an unsolved problem regarding differentiation of benign and malignant liver tumours. Thus, an evaluation of the overall sensitivity and specificity of conventional US and CEUS for diagnosing benign and malignant liver tumours is presented in this systematic literature review and meta-analysis. This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). A search of relevant databases including Scopus, PubMed, and Cochrane Library was conducted from inception to March 31, 2023 using specific keywords. Among the studies included, diagnostic performance was assessed and data was extracted. Average weighted was carried out to calculate the pooled estimates of overall sensitivity and specificity as well as 95% confidence interval (95% CI) by using Wilson score interval of the sensitivity and specificity of the studies. The selected studies were evaluated for reliability using the Quality Assessment of Diagnostic Performance Studies (QUADAS-2). A total of 11 studies involving 1605 patients were included in the study, with publication years ranging from 2022 to 2004. A comparison of conventional US and CEUS showed that CEUS demonstrated high diagnostic accuracy for diagnosing liver tumours. Based on the pooled estimation of diagnostic accuracy (95% CI), liver tumour diagnosis for differentiation of benign and malignant tumours (CEUS: sensitivity: 0.89 [0.87-0.90], specificity: 0.80 [0.78-0.82] and conventional US: sensitivity: 0.51 [0.49-0.53], specificity: 0.44 [0.42-0.53]). It is clear from this study that CEUS has a significant role to play in clinical practice. These results indicate its value in detecting and diagnosing liver tumours, resulting in better outcomes for patients