Background: HRCT is a non-invasive imaging technique that provides detailed images of the thorax, enabling the evaluation of potential malignancies, lung metastases, and pulmonary embolism. In addition, CTPA is an effective tool in diagnosing pulmonary embolism. These imaging modalities aid in the early detection and characterization of chest pain-related pathologies in oncology patients, facilitating timely intervention and treatment. By assisting in the diagnosis and decision-making process, HRCT and CTPA contribute to improving patient outcomes. Methods: This study was conducted at Minya oncology center - Radiology department during the period from July 2022 to September 2023. One Hundred and Twenty (120) oncology patients, suffered from chest pain, were referred from outpatient clinics and inpatient departments in our hospital, to be recruited in the study. All patients underwent HRCT and CT pulmonary angiography. Results: A total of 120 oncology patients was identified, of which 20 (16.7%) developed PE. The incidence of PE was highest in colorectal cancer (30%), followed by breast cancer (25%), female genital tract malignancies and hematolymphoid malignancies (15%). The lowest incidence of PE was found in central nervous system (CNS) malignancies (5%). The most common cause of chest pain was pleural effusion followed by pneumonia, pulmonary embolism, the least common cause was bony chest wall lesion. Conclusion: In our study we found that the most common causes of chest pain were pleural effusion, then pneumonia and pulmonary embolism. We concluded that HRCT and CTPA were helpful tools of choice in evaluating the cause of chest pain in oncologic patients.