Abstract Background The coronavirus disease 2019 (COVID-19) is an acute infectious pneumonia caused by a severe acute respiratory syndrome-coronavirus-2. Some studies have suggested that C-reactive protein, lymphocyte count, and features from CT scoring as predictors of severity and prognosis of COVID-19. Non-contrast chest computed tomography (CT) scan was found to be a useful diagnostic instrument for screening COVID-19 pneumonia. This score uses lung opacification as a surrogate for extension of the disease in the lungs. Aim To assess the prognostic value of chest CT severity score (CSS) to predict the severity of symptoms and outcomes among patients with typical CT findings. Subject and Methods This Prospective Observational study was conducted at Radiology department, faculty of medicine, Ain Shams University on 94 patients. Results There is a significant difference between the groups regarding symptoms severity. there is no significant difference between the groups regarding CT findings. left lung severity scores and total severity score were significantly higher among poor prognosis patients compared to good prognosis patients. mortality rate was significantly higher among poor prognosis patients compared to good prognosis patients. severity score was significantly higher among severe symptoms patients compared to mild symptoms patients in good prognosis patients. Conclusion The current study showed that CT images and CT-severity scores can predict ICU admission and mortality in patients with COVID-19 pneumonia. Clinicians and radiologists can use the CT-severity score as a measure of disease severity and an indicator of poor prognosis, including the need for mechanical ventilation. Also, our findings showed the superiority of CT findings over other clinical information and co-morbidities in predicting the short-term outcome.