The last few years have seen a marked increase in the number of cardiac CT scans performed, regardless of reimbursement issues and concerns about radiation dose. New-generation multidetector CT (MDCT) scanners with wide craniocaudal coverage (256 slices and beyond) have the potential to further improve diagnostic capability compared with that of the existing generation of MDCT scanners. New dose-reduction technologies are now available on these scanners, enabling high-quality coronary imaging with a significant reduction in radiation dose. This article addresses some of these advances and discusses how cardiac CT and its derived information can be used in the preparation and execution of catheter coronary angiography and percutaneous coronary interventions.