Multidetector computed tomography (MDCT) coronary angiography is an accurate, cost-effective, and safe imaging technique in coronary evaluation. An increasing amount of evidence supports the role of MDCT in cardiac protocols, especially with the broad availability of a new generation of scanners. The improved accuracy and safety of MDCT has reduced the need for catheter-based coronary angiography, which in addition to patient-safety benefits is likely to achieve overall cost savings in the diagnostic pathway.