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Background: A CT scanner makes many measurements, from different rotational angles, of X-ray attenuation (weakening in force or intensity) through the cross-sectional plane of the thorax. It then uses these data to reconstruct a digital representation of the cross-section with each pixel of the image representing a measurement of the mean attenuation through the thickness of the predetermined segment. This measurement quantifies the fraction of radiation removed in passing through a given amount of material of a certain thickness. Objective: To compare the chest CT scan and chest x-ray for early detection of pulmonary complications for adults hospitalized in intensive care unit. Patients and Methods: In the present prospective study, we included 40 adults' patients, who were hospitalized in Intensive Care Unit (ICU), in order to compare the diagnostic accuracy of chest X-ray and CT scan for early detection of pulmonary complications. Patients were recruited from the ICUs of Ain Shams University and Misr University for Science and Technology Hospitals. They were included whether they had primary respiratory manifestations or started to develop respiratory manifestations during ICU stay. Results: In the present study, we included 10 patients who were diagnosed with pulmonary embolism. The mean age of the included patients was 59.7 ± 16.3 years old. Five patients were correctly identified by the chest X-ray. Thus, the chest X-ray sensitivity for the detection of pneumonia was 50% and the positive predictive value was 100%. Conclusion: In our cohort of patients with a wide variety of chest disorders, routine chest X-ray was not useful to clinicians in the diagnosis of lung disease, compared to chest CT. In addition, chest X-ray had a very low sensitivity in specific conditions like pulmonary embolism and pneumothorax. [ABSTRACT FROM AUTHOR]