In recent years, technologic advances in multidetector CT have permitted acquisition of virtually motion-free images of the heart and coronary arteries with high spatial resolution. Paralleling these developments has been a growing clinical interest in the application of coronary CT angiography (CCTA) as for noninvasive evaluation of individuals with suspected coronary artery disease. Nevertheless, many questions remain unanswered regarding CCTA use in specific clinical scenarios. This article focuses on contemporary data that relates to the diagnostic performance and potential for risk stratification of the current-generation CCTA. Furthermore, we propose a suggested algorithm for its use in daily clinical practice.