Background: Multislice CT angiography is a recent technique used to diagnose different vascular thoracic diseases with better spatial and temporal resolution.Objectives: To assess the uses of thin slice multidetector row CT in diagnosis of different vascular cause of chest pain.Methods: A total number of 37 patients were classified into 4 groups (I coronary ,II pulmonary, III aorta ,IV Triple Rule Out) according to there clinical manifestations or suspected progression of past condition then they were enrolled for 320 multislice CT angiography using (Ultravist 370 ) as a contrast medium .Results: CT angiography detected coronary significant and non-significant stenoses in the native arteries and evaluated the patency of the grafts, conduits and stents in post interventional cases besides its ability in detecting pulmonary and aortic diseases. Conclusion: CT angiography now a days is considered the primary tool of diagnosis of different thoracic vascular disorders being safe, rapid and accurate method of diagnosis.Triple rule out is a relatively new technique which give us the advantage of screening emergency patients presenting with chest pain in a rapid and safe way for detection of their vascular diseases.