<p>Coronary computed tomography angiography (coronary CTA) provides high diagnostic accuracy for the detection or exclusion of obstructive stenoses in patients with low to intermediate pretest probability; however, the diagnostic accuracy decisively depends on high imaging quality, which in turn requires modern CT systems, thorough patient preparation and optimized examination protocols. According to current guidelines, coronary CTA together with imaging based ischema tests is recommended as a first-line diagnostic modality for suspected chronic coronary syndrome within the low to intermediate pretest probability range (class I‑A indication). It is given priority over other procedures with a class I‑B recommendation; however, this is only true when an unimpaired imaging quality can be expected based on the patient characteristics. A&#xa0;completely inconspicuous result with exclusion of stenoses and the lack of nonobstructive atherosclerotic lesions, confers an excellent prognosis, while the detection of stenoses requires subsequent risk modification, possibly further ischemia diagnostics and potentially invasive management, depending on symptoms and anatomy. The identification of nonobstructive atherosclerosis indicates an increased cardiovascular risk, particularly if plaque burden is high. The threshold for the amount of atherosclerotic plaques to indicate when risk-modifying treatment should be initiated has, however, not yet been clarified by clinical data. Coronary CTA has limited clinical value in patients after prior revascularization and is currently not indicated for risk assessment in asymptomatic individuals due to the lack of sufficiently robust data. Coronary CTA can be useful to clarify cardiac and coronary anatomy prior to repeat bypass surgery or minimally invasive cardiac surgery procedures. This consensus statement outlines the technical requirements and clinical indications of coronary CTA and discusses its integration into patient management in cardiology and cardiac surgery.</p>