Purpose:To compare image quality and the effect of radiation dose reduction after decreasing tube voltage from 120 kVp to 100 kVp for abdominal CT in adults. Materials and Methods: A total of 200 patients who underwent abdominal CT at 120 kVp (n = 100) or 100 kVp (n = 100) were enrolled. Automatic tube current modulation was applied with other scan parameters being constant. Radiation dose was calculated based on CT dosimetry index. The image quality of abdominal organs and image noise were assessed quantitatively and qualitatively. Results: A radiation dose reduction of 13.3% was found in the 100 kVp group. On quantitative analysis, image noise was increased up to 47% in the 100 kVp group. CT numbers of liver, pancreas, renal cortex, aorta, portal vein, and psoas muscle in the 100 kVp group were significantly (p < 0.05) higher than those in the 120 kVp group. Signal-to-noise ratio was significantly higher (p < 0.05) in the 120 kVp group. Contrast-to-noise ratio (CNR) of the liver was higher in the 120 kVp group. However, no significant (p > 0.05) difference was observed in the CNR of other organs between the two groups. On qualitative analysis, noise texture of abdominal organs, artifact, and diagnostic acceptability were not significantly (p > 0.05) different. Conclusion: 100 kVp abdominal CT reduced radiation dose by 13.3% without sacrificing image quality compared to 120 kVp abdominal CT.