Coronary computed tomography angiography is an emerging imaging technique that has attracted much scientific attention over the past years. Improved scanner technology and dedicated protocols have made noninvasive coronary a reliable diagnostic test in patients with suspected coronary artery disease (CAD). Several technical steps such as the introduction of 64-slice scanners, multisegment reconstruction, and dual-source computed tomography have substantially improved temporal and spatial resolution. With these sophistications, coronary computed tomography angiography enables reliable exclusion of CAD in patients with low to intermediate pretest probability of having CAD or with inconsistent ischemia test results.