Spiral CT has a definite role in pediatric neuroimaging. It is fast and offers relatively artifact-free planar and three-dimensional reconstructions. It also provides dynamic vascular phase imaging, a significant decrease in radiation and contrast media requirements, and a potential decrease in sedation while still producing good diagnostic image quality. The complete role of spiral CT angiography in pediatric neuroimaging is, as yet, incompletely explored, but potentially is very useful in the clinical setting of acute head and spine trauma.