Spiral computed tomography (CT) is an imaging modality that utilizes the rapid acquisition of cross-sectional data that can be reconstructed in a number of useful ways. We briefly describe the technology of spiral CT and recent advancements that have made spiral CT feasible. The advantages over conventional CT and angiography are reviewed. Urologic clinical applications are discussed including: detection of a crossing vessel prior to endopyelotomy for ureteropelvic junction (UPJ) obstruction, evaluating renal vascular anomalies preoperatively, and assistance in preoperative planning prior to partial nephrectomy in benign and malignant disease. Spiral CT has numerous advantages over conventional CT and angiography, and will likely have a notable role in future renal imaging.