Coronary artery stenting has become an established treatment for symptomatic coronary artery disease. One of the most important variables that determine the successful clinical outcome of coronary artery stent application is the short- and long-term patency rate of the stents.So far, conventional coronary angiography has been considered the standard of reference for evaluation of the patency and luminal stenosis of coronary artery stents. However, the main drawbacks of conventional coronary angiography for this purpose include invasiveness, patient discomfort, and risk of complications. A less invasive imaging modality is desirable for evaluation of patients suspected of having in stent re-stenosis or occlusion. The use of multi–detector row CT is gaining increasing acceptance for noninvasive cardiac imaging. Recent years with the new emerging machines have demonstrated successful application of multi–detector row CT angiography for the less invasive assessment of coronary artery disease and the evaluation of coronary stents.The aim of this study is to evaluate multi-detector row CT angiography as a less invasive technique in the assessment of the coronary arteries stents. This study included 50 patients with prior coronary stent application , 22 of them underwent conventional angiography as a gold standard for evaluation of the coronary artery stent patency. The indications of angiography were unstable angina in 10 cases (45.45%). The mean age of the included patients was 58 with an age range between 39 and 73 years. Male patients were 44 (88 %) while females were 6 (12%).A total of 95 coronary artery stents deployed within 50 patients were included in this study; and assessed by MSCT for follow up of their patency , 42 stents in 22 cases (44.2 % of the total included stents) underwent conventional coronary angiography. The patients who did not perform the conventional angiography were mostly due to the decision made by the referring physicians as there is increased confidence in the results of MSCT angiography, so those patients were referred for either conservative medical treatment or for angioplasty. Conventional angiography was considered the gold standard technique after correlation of the MSCT with the conventional coronary angiography , 3 stents (7.14%) were non-evaluable by MSCT due to heavy stent struts and narrow caliber [all of them are (2.5 mm) in caliber ] and proved to be patent stents by conventional angiography, while the rest of 39 evaluable stents the following results were found:1) 4 stents (10.25%): were reported to be totally occluded by MSCT and proved their occlusion by conventional coronary angiography .2) 9 stents (23%): were reported to have suspected instent restenosis by MSCT and the conventional coronary angiography revealed that 4 (10.25%) of them have instent re-stenosis while 5 (12.8 %) stents proved to be patent by angiography 3) 26 stents (66.66%): were reported to be patent by MSCT and proved their patency by conventional coronary angiography after re-checking due to clinical conditions recommending so in the form recurrent chest pain and unstable angina . CT angiography compared to the conventional angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 83.8 % , an accuracy of about 87.1 % , PPV is 61.5% and NPV is 100% in the assessment of any type of coronary artery stents.The latest multi-detector row CT scanners show a potential to become a first-line tool for the noninvasive evaluation of patients with suspected instent restenosis. Conventional angiography may be spared for patients who needs an intervention e.g. angioplasty within placed stents or within a native coronary artery.