With the advent of MDCT it is possible to do comprehensive examination for hematuria patients. The imaging plan is to be decided, either to perform thin slice non-enhanced cuts in suspected stone disease or multiphasic series for suspected renal or urothelial lesions or to perform CT urethrography in suspected urethral lesions, depending on the clinical data & previous examinations that the patient had.Multiphasic CT technique performed with a combination of cortico-medullary, nephrographic-phase, and excretory-phase imaging can demonstrate a wide spectrum of disease in those patients using a single modality. Unenhanced imaging can be sacrificed depending on cortico-medullary & nephrographic phase images from kidney to the UB to assess for stones. Then we depend on the three phases in assessment for neoplastic lesions putting in mind the pattern of enhancement of such lesions. Findings at excretory-phase imaging mimic IVU findings and allow excellent evaluation of the collecting systems and ureters. Bladder disease is often well seen on enhanced & excretory-phase images & with virtual cystoscopy.Urethral lesions can be properly assessed by voiding or ascending CT urethrography providing interesting reformat including curved plane, vessel analysis & virtual images, that are informative about the site, extent & degree of urethral stricture & it may be helpful for detection of periurethral lesions like periurethral fibrotic tissue or fistulous tracts.In our study, everyday’s causes of hematuria were almost covered using a 4-detector scanner giving good quality images with informative reformat that was very conclusive compared to the previous traditional examinations that the patient had. Those reformatted images have met good acceptance by the referring urologist that was comparable to the endoscopic & surgical results, proving that MDCT can give accurate evaluation for hematuria patients instead of performing multiple traditional studies that may expose the patient to frequent contrast material & to frequent radiation exposure.