The development of multi-detector-row CT (MDCT), within recent years, dramatically improved image quality and expanded the applications for non-invasive CT angiography. Since the introduction of four-detector-row CT (4-DCT) systems in 1998, MDCT technology has spread rapidly and is now widely available. This technique already meets the requirements for many vascular applications with respect to acquisition speed, anatomical coverage and spatial resolution. The newest MDCT scanners offer the advantages of up to 16 detector rows and gantry rotation as fast as 500 msec, further expanding the possibilities for CT angiography. For the assessment of the aorta and the iliac vessels MDCT has already proven to be superior to single detector CT and comparable to conventional angiography. This article reviews the status of MDCT angiography, including technical aspects, reformation methods and limitations, and clinical applications at the current state of the art.