The progress made by transitioning from axial imaging of soft tissue (with single-detector Computed Tomography (CT) scanners) to volumetric imaging (by multidetector CTs (MDCTs)) has revolutionized vascular studies. CT angiography (CTA) of the abdomen can truly alter management and dispositions. Leaking or dissecting abdominal aortas, along with similar lesions in the iliac vessels, are among the most anxiety-provoking diagnoses for the emergency medicine physician. The search for the cause of intractable chronic hypertension often includes a study to determine whether renal artery stenosis is present. CTA is well-suited to this task. CTA has been shown to be useful in both arterial and venous occlusion in the mesenteric circulation, and to demonstrate whether bowel injury from vascular compromise is present. Data acquisition of thrombus in the inferior vena cava (IVC) or its contributaries from the pelvis and proximal lower extremities can be useful in guiding therapy regarding thrombolysis versus stent placement.