Background: Since its introduction in the early 1970s, Computed tomography (CT) has evolved over time into a useful diagnostic imaging tool with expanding applications, especially in the evaluation of head pathologies Aim: This study aimed at assessing the pattern of head-CT requests, common indications, and findings at a tertiary health center in north-central Nigeria. Methods: We retrospectively reviewed 350 case-files, retrieved from the radiology department's head-CT archives at Benue State University Teaching Hospital (BSUTH) between January and December 2022. Using SPSS version 23 and Microsoft Excel 2007, data was entered into a spreadsheet and analysed. The statistical significance level was set at P< 0.05. Tables, figures, and percentages were used to display the data distribution. Results: Men outnumbered women 2:1 in the 350 head-CT requests that were evaluated. 150 (42.9%) of those scanned were in their second to fourth decade of life, when people are more active and energetic, thus more prone to accidents. Traumatic brain injury (TBI), 77(22.0%) was the commonest clinical indication. The findings were entirely normal in 119(34.0%) head-CTs. The abnormalities that physicians suspected before requesting a head-CT were positive in 231 (66.0%) of the patients. The level of confirmation of abnormality was statistically significant (P=0.001). Conclusion: Men had more head-CTs than women. Most of the patients had the abnormalities that the physicians suspected before requesting a head-CT. TBI was the commonest clinical indication, while majority of head-CTs revealed normal findings. This establishes the pattern of head-CT requests, common indications, and findings for future planning and research.