A number of congenital and acquired conditions may affect the coronary arteries, ranging from very common entities, such as atherosclerotic disease, to very rare coronary anomalies. Some of the conditions that affect the coronary arteries are unique in the body. As a result, readers of cardiac computed tomography are faced with several unique challenges in classifying and stratifying a wide array of diseases. Herein, we discuss some of the technical aspects of coronary computed tomographic angiography and review the spectrum of coronary abnormalities that may be detected with this modality. The typical imaging findings of common and uncommon coronary disease states will be demonstrated.