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Background: Thyroid ultrasound has undergone a dramatic transformation from the cryptic deflections on an oscilloscope produced in A-mode scanning, to barely recognizable B-mode images, followed by initial low resolution gray scale, and now modern high resolution images. Aim: The aim of the present study was to evaluate the diagnostic role of ultrasonography (USG) and multi-detector computed tomography (MDCT) in thyroid swellings, compare the ultrasonographic findings with multi-detector computed tomographic findings and to correlate the radiological findings with histopathological examination (HPE). Materials and methods: The present study was carried out in the Department of Radiology, Kamineni Institute of Medical Sciences, Narketpally. In this study, 50 patients with thyroid gland swellings diagnosed clinically, referred to Radiology Department were selected during the period from October 2008 to September 2010. Histopathological examination was acquired in 35 cases. The study was carried out to observe the sensitivity, specificity and diagnostic accuracy of USG and MDCT in thyroid gland swellings. Results: Maximum number of patients belonged to the age group of 21-40 years that was 27 cases (54.00%) and maximum number of patients were females - 41 cases (82.00%). Most common diagnosis was multi-nodular goitre on USG-16 cases (32.00%) and MDCT-14 cases (28.00%), solitary thyroid nodule is common in the right lobe of thyroid by USG-5 cases (62.50%) and MDCT-5 cases (62.50%). Most common malignancy was papillary carcinoma of thyroid-5 cases (62.50%) and most common inflammatory disorder was hashimoto's thyroiditis-5 cases (10.00%). Conclusion: The present study has concluded that USG is the fast and cost-effective modality of imaging investigation of choice in thyroid diseases and for differential diagnosis of thyroid nodules. MDCT is superior to ultrasound in evaluating retrosternal extension, relations and infiltrations in large lesions. It is also very helpful in evaluating extra-capsular, mediastinal, vascular invasion, lymph nodal involvement and metastasis. MDCT is very crucial in preoperative planning in malignancies of thyroid and large benign lesions. [ABSTRACT FROM AUTHOR]