Background: Currently, sex identification based on sternum measurement is accomplished either by directly measuring dried sternums from cadavers or by indirectly measuring pictures obtained from chest radiography. Objective: The aim of the current work was to obtain an accurate estimation of sex in the forensic identification process by sternal measurements using digital X-ray versus multi-slice CT (MSCT). Subjects and methods: This cross-sectional comparative study included a total of 116 Libyan populations stated in Tripoli (58 males and 58 females) and conducted at Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine at Zagazig University, Egypt, Al Khums Teaching Hospital, Tripoli Medical Center, Zliten Medical Center and Center for Judicial Expertise and Research, Libya. The included subjects were divided into two groups: Group I: included 58 males. and Group II: included 58 females. Sternal measurements using digital X-rays and MSCT scan were done for both groups. Results: ROC assessment showed that manubrium length (ML), mesosternum length (MSL) and sternal index (SI) were the most specific (specificity 54.4, 69, and 71.7% respectively) and the most sensitive (sensitivity 58.6, 69, and 62.1% respectively). Regarding the comparison of different measured parameters of the sternum measurement using MSCT scanning between male and female; the current study demonstrated a statistical significance decrease in ML, manubrium width (MW), MSL, sternebra 1 width (S1W), and sternebra 3 widths (S3W) among male compared to female (< 0.05). The means of ML, and MW were significantly higher among males, while the mean SI was significantly higher among females. Conclusion: It could be concluded that MSCT scanning is superior to digital X-ray radiographs in sex identification and is a useful technique for imaging the sternum.