Abstract Background: Obstructive jaundice arises from interruption of bile flow due to mechanical obstruction of biliary system, leading to accumulation of conjugated bilirubin in the blood. Early and accurate diagnosis is crucial for determining the appropriate therapeutic approach and improving patient outcomes. Computed tomography offers a good anatomical detail for detecting causes, sites and extent of obstructive jaundice. Objective: To compare computed tomography scan findings with surgical and histopathologic results for evaluation of obstructive jaundice at Tibebe Ghion specialized hospital, in 2026 Methods: A retrospective study design using non-probability convenience sampling technique was conducted at Tibebe Ghion comprehensive specialized hospital. Data was collected by kobo toolbox from patients’ chart. Data analysis was done by statical package for social sciences version 27. Descriptive statistics, were used. Chi-square test value and cohen’s kapa value were applied to compare computer tomography with surgical and histopathologic results. Overall diagnostic accuracy of computer tomography scan was assessed. Results: In our study a total of 117 cases were included with a mean age of 54.05 ± 13.76 years, 52.9% were female. Benign etiologies were common (53%). The most frequently site of biliary tree obstruction was at distal common bile duct (28.2%). The accuracy of in identifying site of obstruction were 95.7%. Choledocholithiasis (23.1%) were the most common cause of obstructive jaundice. The sensitivity and the negative predictive value of computed tomography scan for detecting benign causes were 98.4% and 98.1% respectively, while the specificity and the positive predictive value for detecting malignant cause were 92.7% and 93.8% respectively with accuracy of 95.7%. Overall, computed tomography scan had an accuracy of 86.3% in diagnosing causes of obstructive jaundice. Conclusion and Recommendations: Computed tomography scan had 94 % accuracy in identifying site of obstruction and had perfect agreement(k=0.91) and significant statical association with p-value <0.001 for differentiating benign and malignant etiologies and had accuracy of 86.3% in diagnosing causes of obstructive jaundice. Due to its availability and non-invasiveness computed tomography scan could serve as the initial and time-efficient excellent imaging modality for diagnosing various causes of obstructive jaundice.