Objective: To determine the accuracy of high-resolution CT (HRCT) in early diagnosis of COVID-19 in comparison to Reverse-Transcription Polymerase Chain Reaction (RT-PCR). Study Design and Setting: This was a retrospective study, conducted in Department of Radiology, PNS Shifa Hospital, Karachi from April 2020 to June 2020. Methodology: A total of 115 patients were included in the study who presented with symptoms. Patient’s data such as demographic details, clinical presentations, RT-PCR reports and HRCT reports were collected from the record of the hospital. Data was entered and analyzed using SPSS-25. Results: Out of 115 study participants, 98(85.2%) were male and 17(14.8%) were female with the average age of 50.53 (±18.64) years. Fever along with cough was the most common clinical presentation, presented by 91(79.1%) subjects. In comparison to RT-PCR, sensitivity of HRCT was 96.2%, its specificity standing at 60% with the overall accuracy of 93.19%. Moreover, mortality Rate of these symptomatic patients was 11.30% (13 out of 115). The average age of the expired patients was 67.07 (±11.45) years and the age of discharged patients was 48.31 (±17.92) years. The difference in age was statistically significant (p-value <0.001). Conclusion: Highly specific and sensitive diagnostic tests for COVID-19 have not yet been developed. High resolution CT chest has high sensitivity for early diagnosis of COVID-19, hence HRCT should be incorporated as a primary tool in assessment criteria of hospitalized patients for early diagnosis of COVID-19.