Coronary artery disease is atherosclerotic disease of the coronary arteries with the consequent development of ischemic heart disease and is one of the leading causes of death in developed and developing countries. The "gold" standard in the diagnosis of coronary heart disease is invasive coronary angiography, but the development of coronary CT angiography allows for submillimeter-accurate assessment of the heart and coronary artery anatomy. While in the earlier stages, SECT devices with ECG synchronization were used for coronary CT angiography, the development of DECT devices enabled a significant rise in coronary CT angiography in the form of better assessment of anatomy and stenosis of coronary arteries caused by plaque, ability for cardiac perfusion assessment, obtaining image with minimal amount of artifacts, less amount of applied iodine contrast agent, better characterization of atherosclerotic plaque and its components, all with lower doses of radiation for the patient. While the vast majority of research speaks in favour of DECT devices versus SECT devices, the question of inadequate use of many possibilities of DECT devices in everyday clinical practice remains, which is probably due to poor availability, cost and ignorance of DECT devices. DECT technique can be realized in several ways depending on the structure of DECT device (number of radiation sources, structure / arrangement of detectors or use of filters), although the question of which type of DECT technique / device should be used depends on the disadvantages and advantages of individual devices as well as purpose of the diagnostic procedure. As the rapid development of technology will certainly lead to further development, greater availability and use of DECT, further research is needed to confirm the useful clinical impact of DECT in the everyday work process as well as to develop unique protocols that can make the whole process easier and structured with gaining objective results for assessing eventual further conservative treatment or referral to interventional procedures.