The chapter presents the Cardiac CT for the assessment of cardiovascular pathology with an emphasis on the detection of coronary atherosclerosis. Cardiac CT is a robust technology for the non‐invasive assessment for a spectrum of cardiovascular disease processes. This imaging modality can provide assessment of atherosclerotic plaque burden and coronary artery disease risk through coronary calcium scoring. Advances in spatial and temporal resolution, electrocardiographic triggering methodology, and image reconstruction software have helped in the evaluation of coronary artery anatomy and vessel patency, providing the ability to noninvasively diagnose or rule out significant epicardial coronary artery disease. This technique also allows the 3‐Dimensional simultaneous imaging of additional cardiac structures including coronary veins, pulmonary veins, atria, ventricles, aorta and thoracic arterial and venous structures, with definition of their spatial relationships for the comprehensive assessment of a variety of cardiovascular disease processes.