Multi-detector CT (MDCT) has considerable advantage over single-detector helical CT in the form of the shorter acquisition time, greater coverage and superior image resolution. It can be used to systematically evaluate the cardiovascular anatomy, morphologic features of thoracic vessels such as aorta, systemic veins and pulmonary vessels and relationship between the upper lobe bronchi and pulmonary arteries, coronary artery, valves, systemic veins. In diffuse lung diseases, this technique can increase nodule detection and help differentiate between small nodules and vessels. MDCT with three-dimensional (3D) volume rendering provides a unique perspective on thoracic anatomy and disease. MDCT allows shorter acquisition times, greater coverage and superior image resolution. In vascular imaging, this technique provides image quality that equals or surpasses that of conventional angiography. Its use has expanded to aid in diagnosis and surgical planning. In this article we present a pictorial review of the current applications of MDCT in diseases of the thorax.