Spiral CT angiography is a technical innovation in vascular imaging that can produce spectacular three-dimensional reconstructions of the abdominal vessels and organs using modified CT scanning techniques. Rapid volume data acquisition allows contrast material to be imaged in the arterial or venous phase. CT reconstruction in cross-sections avoids superimposition of overlying structures. The combination of these features allows spiral CT angiography to produce extraordinary images of the abdominal vasculature and organs. This review outlines fundamental techniques in spiral CT angiography and summarizes our initial clinical experience at Stanford University Medical Center.