Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 2 2025 07 09 64 72 Hussein Abed Dakhil Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq Suhail Najm Alareer Hayder Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq. Hussein Saleh Abdul Mohsen Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq Adam Norrie Hussein Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq Mustafa Sattar Sjil Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq. Hassan Khayon Mhlhel Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq Ayat Muhammad Touma Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq Maha Hussein Ali Department of Radiology Technologies, College of Health & Medical Technology, Al-Ayen Iraqi University, Thi-Qar, Iraq 2025 01 04 2025 02 07 Multidetector Computed Tomography (MDCT) imaging is a noninvasive tool that does not necessitate sedation and allows accurate assessment of the variceal site and size. Patients experience better tolerance when using MDCT than upper GI endoscopy (EGD). The present study aimed to assess the efficacy of MDCT in evaluating esophageal varices. We conducted a thorough search of international databases (Web of Science, PubMed, Embase, and Scopus) and extracted studies using the appropriate keywords to investigate the efficacy of MDCT in evaluating esophageal varices. The collected data were analyzed using the random and fixed-effects model and STATA (version 15). 17 articles aligned with the inclusion criteria, published between 2008 and 2022, were included in the study. The pooled data of 15 articles on MDCT sensitivity and specificity were 0.87 and 0.82, with 95% CI of 0.85-0.89 and 0.81-0.84, respectively. The meta-analysis of the data from fourteen articles showed a pooled PPV of 0.85 and a pooled NPV of 0.84, with 95% CI of 0.83-0.87 and 0.82-0.85, respectively. Also, our meta-analysis of eight surveys that reported accuracy revealed a high pooled accuracy of 0.92 (95% CI: 0.90-0.93), underscoring the reliability of MDCT in evaluating esophageal varices. These findings strongly suggest that MDCT holds considerable potential as a valuable diagnostic tool for clinicians managing patients with liver cirrhosis and suspected esophageal varices, paving the way for more effective patient care. https://acta.tums.ac.ir/index.php/acta/article/view/11449