Objective This research aimed to assess the efficacy of a novel spatial-temporal polyp detection system in clinical practice. Methods This research was a retrospective comparative study. The experimental group consisted of 833 participants who underwent CADe colonoscopy at the first Medical Center of PLAGH between March and June 2023, while 770 individuals received conventional colonoscopy from March to June 2022, in the identical operation room as the control group. The primary outcome was the adenoma detection rate (ADR), and the secondary outcomes were the polyp detection rate (PDR), adenomas per colonoscopy (APC), and polyps per colonoscopy (PPC). Results The ADR was significantly higher in the experimental group than in the control group (29.3% vs 21.7%, P＜0.001). Adenomas 5mm or smaller and flat-type adenomas were detected in a significantly higher proportion of subjects in the CADe group than in the control group [(23.5% vs 16.1%, P＜0.001) and (15.1%vs 7.3%, P＜0.001), respectively]. The APC and PPC in the experimental group were significantly higher than in the control group[(29.5% vs 18.9%, ?2=15.709, P＜0.001) and (47.3% vs 33.3%, ?2=21.123, P＜0.001), respectively]. The use of CADe significantly increased both ADR and PDR in junior endoscopists [(29.5%vs18.9%, P＜0.001) and (47.3%vs33.3%, P＜0.001), respectively]. However, in senior endoscopists, there was no statistically significant difference in ADR and PDR between the experimental and control groups[(28.8% vs 26.2%, ?2=0.502, P=0.479) and (49.1% vs 45.3%, ?2=0.800, P=0.371), respectively]. Conclusion The use of CADe significantly increases overall polyp and adenoma detection in clinical practice, especially in the detection of diminutive and flat-type lesions. Junior endoscopists are poised to gain greater advantages from the use of the CADe system than their senior peers.