With the advent of multi-detector computed tomography, CT angiography (CTA) has rapidly become the first line imaging modality for detecting extremity arterial injuries in blunt and penetrating trauma patients. A variety of significant injuries are detected with high sensitivity and specificity. The information provided by CTAs in this patient population is often sufficient for making therapeutic decisions, such as the need for and type of surgical or endovascular interventions. Technological advances have allowed for isotropic imaging and improved quality of multi-planar and three-dimensional reformations, which aid in diagnosis and surgical planning. The rapid acquisition speed of 64 multi-detector CT scanners has facilitated integration of CTA into routine trauma CT imaging using a single contrast bolus injection.