Advances in multidetector computed tomography (CT) technology have revolutionized cardiovascular imaging in children. Faster acquisition times and high-quality reconstructions have enabled CT to become a valuable modality for the evaluation of cardiac and vascular pathology. Identification of congenital cardiovascular anomalies and their complications is important for patient management and treatment planning. CT offers an excellent technology in this patient population. The confident diagnosis of congenital cardiovascular lesions requires awareness of the appearances of these defects on CT, before and after surgery. In addition, understanding the techniques for performing CT in the pediatric population, including the risks, is essential for the radiologist.