The role of cardiac computed tomography (CT) in the assessment and management of patients with suspected cardiac chest pain has been formally recognised in NICE guidance 95. When the technique and patient selection are appropriate, cardiac CT is a valuable diagnostic tool, particularly for patients with a low to intermediate pre-test probability of coronary artery disease. The physician must be aware of the implications of the recent guidelines; hence, we present an illustrated synopsis on the current technique and the indications for the use of calcium scoring and cardiac CT in the assessment and management of patients with suspected cardiac chest pain.