Objective:  To investigate the value of multislice CT in detection and characterization of inferior vena cava lesions. Subject and methods: This was prospective follow up study were done between Jaunary 2013 and May 2014 at Zagazig University Hospital. Patients selection was done in a simple random method. Patient inclusion criteria; the age ranging between 3-12 years of any sex, patients with IVC abnormality like abdominal enlargement and symptoms of liver disease or no symtoms with IVC lesions on CT abdomen. The study included 24 patients with a mean age of 7 ± 16.56 years.  Patients were subjected to the following: Complete history taking, full clinical examination, full laboratory investigations, ultrasound with Doppler examination of the abdomen in all cases, multi-slice CT examination of the abdomen in all cases, conventional angiography when  available. Results: Final diagnosis was sex cases with Bud Chiari syndrome, four cases with retroperitoneal sarcoma, two cases with IVC leoimyosarcoma, three cases with retrocaval ureter, three cases with double IVC, two cases with left sided IVC and four cases with Wilms' tumor. MDCT shows accurate diagnosis in all patients in detection, characterization and differentiation of IVC lesions as proved with conventional venography and histopathological correlation. Ultrasound was important as initial screening method, but it was unable to characterize type of IVC thrombus in cases of Wilms' tumor. Conclusion: Ultrasound is important as initial method for screening. Advantages of MDCT include superior spatial resolution; very fast image acquisition; and evaluation of adjacent and distant organs with one single imaging technique. MSCT angiography can be used as an alternative to US, MRI and DSA for evaluation of IVC lesions.