Background: The Critical components of cardiovascular care include the detection and treatment of Coronary Artery Chronic Total Occlusion (CTO). Objective: The major purpose of this research is to evaluate coronary CT angiography (CCTA) and associated scoring systems for their use in assessing candidates for CTO-PCI prior to the actual surgery. We want to learn how these methods improve patient outcomes by making it possible to foresee the degree of difficulty and likelihood of success associated with CTO recanalization. Conclusions: Improvements in the treatment of coronary artery CTOs may be possible with the use of CCTA. Improved patient outcomes are a direct result of CCTA's ability to precisely characterise CTO lesions, facilitate the selection of optimal procedural strategies, and incorporate quantitative parameters for risk stratification, suggesting that CCTA will play a pivotal role in the future of cardiovascular imaging and intervention. Among the many cardiac disorders that contribute to the global burden of death, Chronic Total Occlusion (CTO) in coronary arteries stands out as particularly daunting. When a coronary artery is completely blocked for an extended period of time, it may have devastating clinical consequences for the patient. Over time, the treatment of CTO has progressed from more intrusive methods to less invasive ones, such as percutaneous coronary intervention (PCI). While CTO-PCI has made great strides, reopening occluded arteries is still a challenging and uncertain process.