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Coronary artery disease (CAD) is one of the leading causes of death and disability in the developing world. Invasive coronary angiography is considered the golden standard of diagnosis for CAD. As invasive procedures have an associated mortality (0.15%) and morbidity (1.5%), cardiologists desired to find accurate noninvasive diagnostic tests. More recently, cardiac MDCT has gained popularity for the detection and quantification of coronary artery disease. Cardiac MDCT is the fastest growing noninvasive diagnostic cardiac imaging modality in the China, with dedicated cardiovascular systems available now in most large hospital and outpatient cardiology practices. In addition to coronary angiography, MDCT is commonly utilized for 3-dimensional planning of electrophysiological and surgical procedures, such as radiofrequency ablation, redo-myocardial revascularization and aortic aneurysm and dissection repair. In our paper we will review the current and developing clinical applications in CAD of cardiac MDCT.