Background: Focused assessment with sonography for trauma (FAST), a technological advancement, allowed radiology residents to quickly check patients for injuries at their bedsides. Extended FAST (EFAST) is a recent procedure that scans the lower chest region to detect pneumothorax. Objective: This study aimed to evaluate the accuracy of E-FAST compared with the results of CT as a gold standard in multiple trauma patients. Patients and methods: During the six-month period from June 2021 to December 2021, our prospective, observational, and diagnostic accuracy study, which included 53 patients with multiple trauma and for whom CT scans were performed at the time of arrival in the emergency room, at the Radiodiagnosis Department, Zagazig University Hospital. Results: FAST results in comparison to CT results among the participants indicated that there were 26 true positive diagnosis of hemothorax and pneumothorax, while 3 were false negative. There were 25 had true positive diagnosis of hemoperitoneum among them 18 had true positive solid organ injury while 3 had false negative diagnosis of hemoperitoneum among them 1 had false negative diagnosis of solid organ injury Conclusion: E-FAST examination has an excellent specificity as considered as a useful diagnostic procedure for the primary assessment of trauma patients in ED. However, the sensitivity detected is not high enough to rule-out thoraco-abdominal injuries in multiple trauma patients. It is also a portable and non- invasive procedure but is operator dependent.