Objective To evaluate the value of near focus narrow-band imaging (NF-NBI) in differentiating hyperplastic polyp (HP) and sessile serrated adenomas/polyps (SSA/P). Methods Data of 65 cases of pathologically confirmed HPs or SSA/Ps with clear NF-NBI images from October 2017 to September 2018 were retrospectively analyzed. Three senior doctors observed the images of NF-NBI, including dilated crypt opening (ECO) and thick & branched vessel (TBV). The results were compared with pathological resultsin order to analyze differential diagnostic value of ECO and TBV for HP and SSA/P. Results Among 65 lesions, 44 were SSA/P and 21 were HP. The sensitivity, specificity, and accuracy of ECO for SSA/Ps, TBV, and ECO combined with TBV were 80.3%(106/132), 85.7%(54/63) and 82.1%(160/195); 38.6%(51/132), 82.5%(52/63), and 52.8%(103/195); and 84.8%(112/132), 73.0%(46/63), and 81.0%(158/195), respectively. Conclusion ECO under NF-NBI has a high sensitivity for diagnosis of SSA/P. ECO combined with TBV is helpful for differential diagnosis between HP and SSA/P.