Recent technical advances in computed tomography (CT) have improved image quality, diagnostic performance and accuracy of coronary CT angiography (CCTA). Latest dose-reduction strategies reduce radiation dose to an acceptable level even lower than that from conventional coronary angiography. CCTA is a noninvasive imaging modality which can effectively show complex coronary artery anatomy, variations and congenital anomalies of the coronary arteries. Congenital coronary artery anomalies are rare entities, but sometimes have a potential of producing fatal consequences. CCTA is now the primary imaging modality for the evaluation and diagnosis of coronary artery anomalies. Reporters should, therefore, have knowledge of the normal coronary artery anatomy and variations, and understand the different types of coronary artery anomalies and their respective prognostic implications in order to provide correct diagnosis and to prevent undesirable mistakes during interventional and surgical procedures.