Introduction: Cardiomegaly is defined as a pathological increase in cardiac volume. The cardiothoracic index is a simple parameter to assess the size of the heart on the frontal chest radiograph. The aim of our work was to study radiographic cardiomegaly in adults at Kati University Hospital. Material and Methods: This was a descriptive, prospective study, which took place over a period of 11 months. All chest x-rays with cardiomegaly taken in the medical imaging department of Kati University Hospital during the study period were included in our study. These radiographs were associated with patient clinical files. Results: The average age of our patients was 57±16.34 years. The frequency of cardiomegaly was 10.40% of chest radiographs. Cardiomegaly was isolated in 49.8% of cases. Dyspnea alone or associated with other signs represented 58.2% of the reasons for consultation. The ICT between [0.56-0.6] was in the majority with 29.1% of cases. Hypertension represented the most common risk factor with 46% of cases. Conclusion: The cardiothoracic index is a simple parameter to evaluate the size of the heart on chest radiography. The frequency of radiographic cardiomegaly was 10.4% of chest radiographs.