We describe the use of a dual-source 64-channel multidetector array CT (MDCT) scanner in the evaluation of a coronary-cameral fistula in a 10-month-old boy. Echocardiography, cardiac catheterization, and MRI are modalities often used to evaluate congenital and other pediatric heart diseases. Radiation dose concerns and the absence of established protocols are factors that have potentially limited the use of CT for work-up in these young children. We present a case in which recent advances in technology allowed effective low-dose diagnostic quality coronary MDCT angiography in an infant.