The anatomical evaluation of the coronary arteries, the clinical indication for revascularization procedure and followup of patients has always been prerogative of invasive coronary angiography. However this technique has several disvantages. First, it is invasive and associated with a not neglegible incidence of adverse events. Second, it is expensive and last the information obtained via catheter-based coronary angiography pertains to the coronary arterial lumen alone.The introduction of multidetector computed tomography scanner associated with high-speed and ECG-gated x-ray tube allowed an increase in spatial and temporal resolution such as to consider this technology a valuable alternative to the invasive coronary angiography. The aim of this review is to describe tecnical background, clinical applications and issues of radiation exposure of this new promising diagnostic method.