With advancements in temporal and spatial resolution, CT has excellent diagnostic characteristics for non-invasive evaluation of coronary artery disease in appropriate patients. Nevertheless, clinical usefulness of diagnostic testing requires not only high diagnostic accuracy but also risk stratification for patient management. Current guidelines for risk stratification of patients with coronary artery disease rely primarily upon functional testing; alternatively, anatomic risk stratification may also be performed with invasive coronary angiography. This article reviews current and emerging concepts in the prognostic value of cardiac CT angiography.