Familiarity with the CT features of pulmonary vascular disease, including pulmonary embolism and pulmonary hypertension, is essential to ensure diagnostic accuracy. Acute and chronic pulmonary emboli have characteristic imaging findings; however, the diagnosis of pulmonary embolism can be challenging due to the high prevalence of image artifacts. Foreign materials may also embolize within the pulmonary arterial system. While relatively uncommon, pulmonary hypertension is disorder where accurate interpretation of CT imaging features is of critical importance. The World Health Organization (WHO) has defined a classification scheme with five groups of pulmonary hypertension patients. Characteristic lung parenchymal findings, in addition to pulmonary arterial abnormalities, are useful in distinguishing the etiology of pulmonary hypertension and in determining the most appropriate management.