Introduction: The radiological investigations are not diagnostic of COVID-19 disease but help in management. CT scan is not available worldwide; therefore, x-ray chest (CXR) is ideal for assessment of disease severity using scoring system. This study was conducted to see various CXR findings and relation of severity with outcome. Materials and Methods: This study was conducted at Dallah hospital Saudi Arabia. All admitted confirmed cases of COVID-19, above age of 18-year were included. CXR were done at baseline, after 5-7 days and after 13-15 days. Patient with previous heart failure, chronic obstructive pulmonary diseases or pulmonary fibrosis, Pregnant and lactating ladies were also excluded.Results: Out of total 629 patients 67.6 % were males. There was no statically significant difference in mortality in male to female patients. The mean age was 42.67+15.13 (range 18-83) years. Patients with age more than 50-year were 58.9% and had severe infection (p=0.041) with high mortality (p=0.045). The 63% patients had abnormal CXR at baseline. The common CXR features detected were consolidation (45%), followed by ground glass appearance (43%). Only 0.8% patients had pleural effusion and one patient with pneumothorax. Patients with bilateral lung infiltration was 67.5% and mostly it was in lower zones (63%). The follow-up CXR revealed an increase in severity score related to mortality (p<0.001). Conclusion: In COVID-19 infection CXR may be a predictor of severity of disease and monitoring of disease may be done by serial CXR.