Beyond the assessment of coronary artery anatomy, multi-detector computed tomography (MDCT) can be used to provide detailed structural evaluation of multiple non-coronary structures. The purpose of this review is to provide a clinical update on the evolving niche applications of MDCT in the assessment of non-coronary structures, including the assessment of the left ventricle for perfusion and scar, the evaluation of the right ventricle, pericardium and coronary anomalies. Additionally, the roles of MDCT in the assessment of congenital heart disease and intra-cardiac masses will be reviewed.