Iterative techniques are a valuable computed tomography image reconstruction alternative to filtered back projection. In repetitive cycles, iterative algorithms reduce image noise virtually independently of spatial resolution. In light of substantially decreased image noise, tube voltage or current reductions are enabled, resulting in significant radiation dose savings while preserving image quality. Moreover, iterative reconstruction techniques have the advantage of minimizing calcium blooming and metal artifacts. Iterative reconstruction may therefore lead to more exact coronary artery evaluation at constant x-ray tube settings and appears beneficial in clinically challenging scenarios such as overly obese patients, calcified coronary arteries and presence of iatrogenic hardware. For cardiac computed tomography, iterative reconstruction represents a promising and readily available tool.