In recent years, technical advances and improvements in cardiac computed tomography (CT) have provoked increasing interest in the potential clinical role of this technique in the non-invasive work-up of patients with various cardiac diseasesmost importantly in patients with suspected coronary artery disease (CAD) -and have initiated discussions on correct patient selection for this emerging imaging technology. A huge number of publications have abounded evaluating the diagnostic performance of CT coronary angiography in detecting significant coronary artery disease. With continuous development in CT system generations, the diagnostic accuracy increased steadily. During the first years of cardiac CT, technical improvements focused on the increase of detector rows, enabling faster scans with less contrast agent volume and improved robustness of the technique. In recent years, with the introduction of wide detectors with 256 or even 320 detector rows, as well as with the advent of Dual-Source CT scanners, scanning of the heart within one or two heart beats became feasible, as well as new options such as dual energy imaging of the heart or highly radiation dose-efficient protocols, e.g. applying highpitch scanning protocols. These options can broaden the clinical applications of cardiac CT, such as the depiction of myocardial changes, e.g. myocardial infarctions or perfusion defects, or -due to scanning options with less than 1mSv equivalent dose -including younger patients, even infants, e.g. with congenital heart disease. Learning Objectives: