Objectives: Contrast-associated acute kidney injury (CA-AKI) and its associated risk factors subsequent to coronary angiography have been extensively examined, leading to the development of a widely acknowledged risk score. However, there is a paucity of evidence regarding CA-AKI after contrast-enhanced computed tomography (CECT), and a risk score specifically tailored for CA-AKI following CECT is currently absent. Methods: All adult patients who underwent CECT between January 1, 2018, and December 31, 2022, at Thammasat University Hospital were included. Patients with chronic kidney disease (CKD) stage 5, those who underwent dialysis within 1 week prior to CECT, or those with incomplete essential data were excluded. CA-AKI was defined based on creatinine criteria from the KDIGO guideline. Multiple logistic regression was employed to identify risk factors, and bootstrap analysis was performed for internal validation. Male gender, hospital admission (both non-ICU and ICU admission), hemoglobin levels of <10 g/dL, and estimated glomerular filtration rate (eGFR) of <90 mL/min/1.73m² (with subcategories: 60-89, 45-59, 30-44, and 15-29 mL/min/1.73 m²) were identified as independent risk factors for CA-AKI. These risk factors were assigned weighted integers, and the sum of these integers constituted a total risk score for each patient. Results: A total of 15,090 patients were enrolled, with 6,039 meeting the inclusion criteria. The mean eGFR among patients was 58.9 (26.2) mL/min/1.73 m². Of these, 516 (8.5%) patients developed CA-AKI, and 47 (0.8%) required dialysis treatment. The incidence of CA-AKI was 4.4%, 10.6%, 45.1%, and 64.7% for low (<5), intermediate (5-10), high (11-15), and very high (>15) risk scores, respectively. The model exhibited good discriminative power with an area under the AUROC of 0.71 (0.69-0.74). Conclusions: CECT can lead to CA-AKI in specific populations. The Pre-CT AKI risk score for CA-AKI following CECT demonstrated good discriminative power and can be easily applied in clinical practice.