Retrospective review of patients with cerebral venous thrombosis (CVT) detected by 64-slice multidetector row computed tomography (MDCT). To evaluate the role of CT scan as the primary modality of imaging in suspected cases of CVT. Between October 2006 and September 2007, 53 patients, suspected to have CVT, underwent CT scan of the brain. Out of these, 33 patients were included in the study, who underwent non-contrast CT (NCCT), CT venous angiogram (MDCTA) and magnetic resonance venogram. Two blinded readers evaluated the NCCT and MDCTA. Final diagnosis was obtained after consensus reading of all the imaging by the two readers. Out of the total 33 patients, 20 patients were detected to have thrombosis of one or more of the cerebral venous sinuses or veins, at the concluding consensus reading. MDCTA together with NCCT could identify thrombosis in all of the 20 patients, i.e., 100% sensitivity and specificity. Sixty-four-slice MDCTA together with NCCT provided 100% sensitivity and specificity for the identification of CVT. It can be considered as a cost-effective and widely available, primary imaging modality in emergency situations.