This study evaluated the diagnostic accuracy of ultrasound versus CT scans in diagnosing pleural effusion across 53 patients, incorporating demographic data, medical histories, and diagnostic outcomes. Ultrasound demonstrated a sensitivity of 95.31%, a specificity of 90.48%, a Positive Predictive Value (PPV) of 93.85%, a Negative Predictive Value (NPV) of 92.68%, and an overall accuracy of 93.40%. In the comparative analysis of for characterizing pleural effusion, ultrasound significantly outshone CT in detecting septations or debris, boasting a 100% detection rate against CT's 25%, a disparity underscored by a p-value of 0.007, highlighting ultrasound's superior diagnostic sensitivity for these features. In contrast, for loculation detection, CT demonstrated a higher efficacy with a 100% detection rate, surpassing ultrasound's 66.7%. However, this apparent advantage of CT did not translate into a statistically significant difference, as indicated by a p-value of 0.455, suggesting that the practical difference between the two modalities might be less critical than it appears, potentially due to sample size constraints or the variable nature of loculations .he resultTs obtained demonst