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Abstract Pulmonary arterial hypertension was previously considered a rare untreatable condition. The past two decades have seen major changes in our understanding of the spectrum of disease affecting the pulmonary circulation. More than 30 randomized controlled trials (RCTs) of treatments have been performed, and surgery for patients with chronic thromboembolic pulmonary hypertension has been developed. Advances in imaging have enabled more detailed patient assessment, but pulmonary arterial hypertension continues to be a life shortening condition, and there is nearly about two years delay in diagnosis from the onset of symptoms . Main trunk ,right and left main pulmonary arteries diameters, ratio between pulmonary artery to ascending aorta diameters, ratio between left and right ventricles diameters, IVC, SVC and hepatic veins congestion in CT pulmonary angiography and it was correlated to echocardiography in diagnosis of PAH to assess the ability of MDCT in diagnosis of PAH. The study included 36 patients, ranging in age from 16 to 83 years who underwent CT chest and echocardiography, The results obtained were collected, calculated, and submitted for statistical analysis. We found that pulmonary artery diameter was a good indicator for pulmonary hypertension with a sensitivity 77.3% and specificity 64.3 % using a cut off value 29 mm |