Objective To assess the clinical value of multi-detector computed tomography(MDCT) source image on detecting extrapulmonary abnormalities in a large cohort of physical examination patients. Methods MDCT source images from 1866 consecutive physical examination patients(mean 51.2 years) were reviewed retrospectively by 2 readers. Extra-pulmonary findings were classified according to involved organ and level of clinical significance. Clinical relevance of extracoronary findings was considered as either "non-significant" or "significant". "Non-significant" findings were subclassified as score 1: findings without clinical implication findings necessitating immediate therapeutic actions. "Significant" findings were assigned to score 2: findings with uncertain clinical or prognostic relevance, requiring clinical awareness, follow-up or further investigations(non-urgent), or score 3: findings necessitating immediate therapeutic actions. The irrelevant incidental findings (C-spinal or T-spinal degenerative changes) were not analyzed. Results Extrapulmonary findings was evidenced in 660 patients with 941 abnormalities. 17.9%(118/660) patients had multiple lesions, 5.8%(55/941) lesions were located in the breast, 44.0%(414/941)lesions found in the upper abdomen, 41.6%(391/941)lesions evidenced in the mediastinum, 2.0%(19/941)lesions seen in the spine, 6.6%(62/941)lesions located in the thyroid. The clinical significance score 1-3 was 8.5%(36/941), 81.1%(344/941) and 10.4%(44/941) respectively. Conclusion Our data show that there is clinical value to observe and report extrapulmonary findings with source image of pulmonary MDCT.