Sudden cardiac death (SCD) is the leading cause of death in the U.S., and many of these events are attributable to malignant ventricular arrhythmias such as sustained ventricular tachycardia (VT). Most of the efforts to identify arrhythmia precipitants in these patients are based on imaging to look for myocardial or coronary artery disease. As advances in cardiac computed tomography (CCT) are made, it has demonstrated its usefulness in identifying structural intracardiac pathology and measuring parameters of cardiac anatomy and function. In this article we review the different etiologies of VT/SCD that are identifiable by CCT, and its potential usefulness in the workup for VT/SCD.