Cardiac CT (CCT) is rapidly evolving as a noninvasive imaging modality. Newer technologic developments in CCT allow the comprehensive assessment of cardiovascular anatomy, including the coronary arteries. There are special considerations regarding obtaining and accurately interpreting CCT studies. On completion of this article, the reader should be able to describe the issues related to adequate patient preparation and acquisition and interpretation of CCT studies, recognize specific limitations that impair image quality and subsequently the accuracy of diagnosis, and list the current indications and future potential applications of this technique.