This paper reviews progress using X-ray computed tomography to study damage accumulation. Since its introduction, X-ray microtomography has been used to diagnose the presence of damage. In this review, a wide range of damage-accumulation mechanisms are covered including cavitation, fracture, microcracking, fatigue cracking, and stress corrosion cracking. In this regard, the advantages of attenuation and phase contrast imaging are discussed. This review includes both measurements of damage accumulation, taken postmortem, and the incremental monitoring of damage-accumulation processes during life (sometimes termed four-dimensional tomography). In addition to the qualitative diagnostic studies, the quantitative analysis of tomography images to extract key failure parameters is examined. ; Times Cited: 3 Withers, Philip J. Preuss, Michael