Introduction: Hematuria has a prevalence rate of 2% to 31% in the population and is therefore a common reason for imaging of the urinary tract. Hematuria has many causes ranging from urinary tract infections to carcinoma. Imaging plays a major role in the investigation of hematuria frequently determining the underlying cause and influencing management. Computed tomography (CT) is increasingly valuable tool for assessing the urinary tract in adults and children. However, its imaging capabilities, while overlapping in some respects, should be considered as complementary, as each technique offers specific advantages and disadvantages both in actual inherent qualities of the technique and in specific patients and with a specific diagnostic question. The use of CT should therefore be tailored to the patient and the clinical question. Aim of the work: Evaluation of CT as imaging techniques for assessment and diagnosis of causes of hematuria and to study the CT features of various etiologies causing it. Patients and Methods: A prospective observational study included 42 cases have hematuria (gross & microscopic) were examined using MDCT. They are presented to the outpatient clinic of the urology and radiology department at Sohag university hospital between September 2015 and September 2018. A written consent was taken from the patients included in the study. An approval was taken from the scientific ethical committee before starting in the protocol of this study. Results: All causes of hematuria of urologic origin were almost covered using multidetector CT that was very conclusive compared to the previous traditional examinations that the patient had. These images have met good acceptance by the referring urologist that was comparable to endoscopic and surgical results, proving that MDCT can give accurate evaluation for hematuria instead of performing multiple traditional studies that may expose the patient to frequent contrast material & to frequent radiation exposure. We recommend CT as an initial investigation of hematuria and appropriate protocol should be tailored for each patient. Conclusion: CT can diagnose wide spectrum of diseases associated with hematuria with good accuracy and considered the initial and comprehensive imaging modality for evaluation of hematuria.