Objectives <p>Develop consensus-based recommendations for infection, prevention and control (IPC) practices in CT regarding (1) guiding principles for Intravenous (IV) Contrast training and compliance and (2) best practices for the use of IV contrast.</p> Materials and methods <p>A modified e-Delphi study was conducted with a panel of experienced CT radiographers and nurses from healthcare settings across Australia. Nineteen statements were presented to participants who selected a response on a 5-point Likert scale from ‘strongly agree’ to ‘strongly disagree’ using an online survey. Participants were invited to provide justifications regarding their selected responses. Consensus was defined as ≥ 75% agreement, and any statement that fell below this benchmark was modified for subsequent rounds based on participants’ comments.</p> Results <p>Three rounds were conducted, with the number of participants per round being 34, 26 and 24, respectively. Eighteen statements reached consensus, and pertained to guiding principles for IV contrast, sequencing IV contrast administration, single- and multi-use IV contrast administration systems and IPC considerations in the CT environment. Statements that failed to reach consensus (<i>n</i> = 1) or lost stability across subsequent rounds (<i>n</i> = 3) related to dripped contrast and connection/disconnection of the contrast tubing to the patient.</p> Conclusion <p>This study established a set of eighteen IPC Guiding Principles and Best Practice statements for staff administering IV contrast in CT departments in the Australian healthcare setting. Findings underscore the importance of standardising IPC training and clearer communication of IPC policies. These results can inform policy updates and guide future education.</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p><b>Question:</b> CT IPC practices vary, with no clear, relevant guidelines.</p> </ItemContent> <ItemContent> <p><b>Findings:</b> Eighteen consensus statements guide CT IPC practices for IV contrast administration. Expert-led consensus statements enhance CT IV contrast practice, supporting safer departmental procedures.</p> </ItemContent> <ItemContent> <p><b>Critical relevance statement:</b> CT IV contrast administration practices vary across practitioners and departments; however, standardised guiding principles and best practice recommendations can support improved infection control for radiology departments, educators, and policymakers aiming to enhance infection control within diagnostic imaging.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>