Currently, computed tomographic (CT) imaging of the heart is mainly used for the quantification of coronary artery calcification as an indirect measure of coronary plaque burden and, less frequently, for minimally invasive coronary angiography. Recently, so-called multislice spiral computed tomographic (MSCT) scanners with gantry rotation speeds fast enough to produce diagnostic images of the heart under certain conditions have become widely available. As a consequence, cardiac CT imaging, most often performed for the purpose of calcium scoring, is increasingly applied. In this paper we provide a discussion of technical issues, applications, advantages, and limitations, after which we offer recommendations for current and future uses. To accomplish this, we conducted a comprehensive review of a study (Stacul et al. 2009) that was done to analyse the costs of 64-slice computed tomography (CT) coronary angiography and conventional coronary angiography and determine the cost-effectiveness of the two modalities.