Objective <p>To evaluate abdominal computed tomography (CT) findings in patients with Crimean-Congo hemorrhagic fever (CCHF) and investigate their associations with laboratory parameters, disease severity, and in-hospital mortality.</p> Methods <p>This retrospective cohort study included 62 patients with serologically confirmed CCHF who underwent abdominal CT during the acute phase of illness. CT images were analyzed for hepatosplenomegaly, free intraperitoneal fluid, gallbladder wall thickening, pericholecystic fluid, and other findings. Laboratory parameters and clinical outcomes were recorded. Associations between CT findings, laboratory markers, and mortality were assessed using appropriate statistical analyses.</p> Results <p>The most common CT findings were hepatomegaly (83.6%), pleural effusion (56.5%), free intraperitoneal fluid (54.8%), omental/mesenteric inflammatory changes (50%), and gallbladder abnormalities, including wall thickening (52.7%) and pericholecystic fluid (40.3%). Free intraperitoneal fluid was significantly associated with lower platelet counts (<i>p</i> = 0.013) and fibrinogen levels (<i>p</i> &lt; 0.001), as well as higher INR (<i>p</i> = 0.006) and PT values (<i>p</i> = 0.019). Overall mortality was 37.1% and showed significant associations with abnormal laboratory parameters and CT findings, particularly pleural effusion, extensive abdominal fluid, and gallbladder abnormalities (all <i>p</i> &lt; 0.05).</p> Conclusion <p>Abdominal CT frequently detects hepatobiliary abnormalities—particularly hepatomegaly, periportal edema, splenomegaly, and gallbladder involvement—as well as ascites in patients with CCHF. These findings reflect hepatic and vascular involvement and may serve as important prognostic indicators, aiding in risk stratification and timely clinical management. Further prospective studies with larger cohorts are warranted to validate CT-based imaging biomarkers for predicting outcomes in CCHF patients.</p>