Fast, cross-sectional computed tomography (CT) imaging permits visualization of the coronary artery lumen after intravenous injection of contrast agent. Electron beam CT and multidetector row spiral CT have both been shown to allow detection of coronary artery stenoses with high sensitivity and specificity in selected patient subsets. However, limitations of image quality may render some coronary artery segments unevaluable, in most cases because of severe calcification or remaining motion artifacts. In the future, these imaging modalities may play a clinically important role in ruling out coronary artery stenoses, especially in patients with relatively low likelihood of disease. Other applications include the analysis of bypass patency and evaluation of coronary anomalies.