Computed tomography (CT) imaging is invaluable in evaluating patients presenting with swollen limbs in the emergency department, providing detailed visualization of anatomical structures useful for diagnosis and management. While clinical assessment remains fundamental, CT plays a crucial role in cases where additional information is needed, offering high-resolution images of bone, soft tissues, and vessels. Contrast-enhanced CT enhances vascular visualization, aiding in the detection of anomalies or occlusions. Limb swelling presents with a myriad of differential diagnoses, categorized as bilateral or unilateral. Indications for emergency CT include rapid evaluation of vascular, traumatic, inflammatory, and infective causes. Imaging techniques must be rapid and efficient, employing specific protocols for limb evaluation. CT assists in diagnosing various pathologies, including deep vein thrombosis, superficial thrombophlebitis, and venous thoracic outlet syndrome. Additionally, it aids in assessing acute arterial ischemia, joint effusion, hematomas, compartment syndrome, arthritis, soft tissue infections, osteomyelitis, muscle injury, rhabdomyolysis, and Baker’s cyst. Despite some limitations, CT remains an indispensable tool in the emergency setting, guiding timely and accurate diagnosis and facilitating prompt interventions to improve patient outcomes.