<p>Cardiac computed tomography angiography (CTA) is a valuable tool in the assessment of congenital and acquired cardiac disease in children. The goal of cardiac CTA is to produce images that are free of motion and provide sufficient characterization of the anatomy in question. Given the complexity of pediatric patient characteristics, including patient size, heart rate, breath-holding capability, and variant anatomy, cardiac CTA technique must be individualized to the patient as well as the indication to answer the clinical question while also minimizing radiation exposure. The purpose of this article is to discuss the variables that can be adjusted to optimize imaging including cardiac gating, scanner specifications and computed tomography technique, temporal resolution, contrast resolution, intravenous access, and contrast administration.</p> Graphical Abstract <p></p>