Appropriate patient selection for cardiac CT imaging is paramount and heavily tested. This chapter is high yield, encompassing ~ 11% of the CBBCT exam. Understanding which populations of patients CT imaging is contraindicated is equally crucial. This chapter will also discuss necessary pharmacotherapy, including nitroglycerin and negative inotropic agents, as well as their appropriate use. As new evidence emerges, so does new appropriate use criteria and guidelines. Recall that the board exam in general lags behind latest evidence 1–1.5 years.