In the Russian Federation, the death rate from cardiovascular disease is more than 56%. The main reason is atherosclerotic coronary artery disease, which leads to the development of coronary heart disease, and myocardial infarction. In the past, the only way to accurately diagnose coronary heart disease was invasive coronary angiography. This technique is deservedly referred to as the "gold standard" due to its high information content. However, coronary angiography is associated with the necessity of hospitalization in a hospital, as well as possible complications inherent in any invasive procedure. Having been in clinical practice multislice computed tomography has opened opportunities for the study of minimally invasive coronary artery status in patients with suspected coronary heart disease. The purpose of this work is to determine the diagnostic possibilities and optimization techniques of multi-detector computed tomographic coronary angiography. The study involved 38 patients with atherosclerotic coronary arteries, anomalies of the coronary arteries, and patients after stenting. The study was performed on a 64-slice “Aquilion 64” and 320-slice “Aquilion One” Toshiba computed tomographic machines. Analysis of the results of multi detector computed tomographic coronary angiography showed high diagnostic information value of this method in the assessment of coronary disease, in determining the type of blood supply distributed by the heart, in the visualization of the peripheral regions of the coronary arteries, and in the assessment of stents. Multi detector com-puted tomographic coronary angiography with 320-slice computed tomographic machine with one volume scan, shows a significant reduction of radiation exposure on the patient.