Noninvasive imaging techniques provide a window to atherosclerotic disease in vivo. Multidetector CT angiography represents a potential clinical tool to monitor carotid atherosclerosis, since it is a robust, readily available, and fast technique and it enables (semi)automated quantification of luminal measures as well as of plaque burden and plaque composition. This chapter reviews the state-of-the-art CTA technique used to evaluate carotid artery stenosis and atherosclerotic plaque.