This article reviews published data regarding CT colonography and discusses both technical and medical aspects of its development over the last 10 years. Although colonography can be performed using MRI instead of CT, mainly CT aspects are dealt with. The technical development of CT to the current generation of Multi-detector-row-CT is explained, and the influence of various factors (slice thickness, dose, patient preparation, post processing) is discussed. The method has a high sensitivity and specificity as well as a high negative predictive value for the detection of polyps > or = 1 cm, but is currently still insufficient in the detection of polyps < 5 mm. It is a valid alternative after incomplete optical colonoscopy and an alternative in patients with "high-risk" for conventional endoscopy. In the future it may become an alternative for conventional endoscopy in screening programs for colorectal cancer.