Background: Renal cell carcinoma (RCC) is the most common malignancy of the kidney, and accurate preoperative diagnosis is critical for treatment planning. Contrast-enhanced computed tomography (CT) is frequently used for RCC diagnosis, but its correlation with histopathological findings is not fully explored, especially in Bangladeshi patients. This study aimed to evaluate the correlation between CT scan findings and histopathological diagnosis in RCC. Methods: A retrospective study was conducted at the National Institute of Kidney Diseases and Urology, Dhaka, from January 1, 2019, to June 30, 2020. A total of 150 patients diagnosed with RCC based on CT scans and confirmed by nephrectomy and histopathological analysis were included. CT scans were assessed for tumor size, morphology, necrosis, calcifications, and lymph node involvement. Histopathological diagnoses were compared with preoperative CT findings to evaluate diagnostic accuracy, sensitivity, specificity, and concordance. Results: Among the 150 patients, 68.7% had clear cell RCC, and 59.3% of tumors showed solid masses with necrosis on CT. The concordance rate between CT scans and histopathology was 92%, with false positive and false negative rates of 4% and 2.7%, respectively. Tumor size greater than 4 cm was observed in 78.7% of cases, and 28% of patients had lymph node involvement. Conclusion: CT scans demonstrated a high correlation with histopathological findings in RCC diagnosis. This supports the use of CT scan as an accurate tool for preoperative assessment, aiding in treatment decisions.