Background: Multislice CT is a recent development in the spiral CT that allows ECG-gated complete coronary coverage in a reasonable time. Objectives: To investigate the ability of MSCT coronary angiography, using the new generation of CT scanners to detect and evaluate the coronary artery anomalies.Conclusion: CT angiography permits non-invasive coronary imaging that offers excellent spatial resolution with the possibility of performing multiplanar reconstructions, maximum intensity projections and volume rendering that allow visualization and clarification the type and the course of the coronary artery anomalies. In this regard, MSCT is the first-choice modality to diagnose anomalous coronary arteries in elderly patients who are likely to have atherosclerotic coronary artery disease.