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Abstract Esophageal varices (EV) development is a common complication of liver cirrhosis, which leads to hematemesis with high morbidity and mortality rates. Esophagogastroduodenoscopy (EGD) is the gold standard for diagnosis and grading of esophageal varices. The use of EGD as a method of screening is limited, as it is invasive, needs sedation, and low compliance from patients. So, searching for an alternative non-invasive method for diagnosis of EV is very necessary. In our study we evaluated the role of Triphasic MDCT in diagnosis and grading of EV compared to upper GI endoscopy as a newly evolving, noninvasive procedure and its acceptance to the patients. A prospective study was carried out on 100 cirrhotic patients (60 males, 40 females) with mean age of 49.9 years throughout the period from November 2017 to November 2018. All patients had MDCT Triphasic study followed by EGD within one week from Triphasic MDCT study. In our study, the sensitivity, specificity, positive and negative predictive values and accuracy of Triphasic MDCT for defining EV in all grades were 99.5%, 99.6%, 99.4%, 99.5% and 99.5% respectively. In our study, the performance characteristics of Triphasic MDCT have been proved to be superior to EGD for the detection and evaluation of other important extra-esophageal abnormalities, such as splenomegaly, ascites, HCC and gastric sub-mucosal varices |