Multidetector computed tomography angiography (MDCTA) is a non-invasive and accurate technique for assessment of many acute and chronic thoracic aortic abnormalities. Recent advancement of MDCT provides high-resolution axial images with optimal contrast enhancement and 3D reformatted images of the thoracic aorta. This essay reviews the procedural considerations of MDCT imaging of the thoracic aorta: acquisition parameters, contrast injection and processing techniques, and the imaging findings of thoracic aortic diseases including aortic aneurysms, aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer, traumatic injury, inflammatory disorders, and congenital malformations as well as assessment of the postoperative aorta and aortic stent grafts.