Volumetric CT data acquisition has had a major impact on the practice of computed tomography. This article reviews the current state of knowledge of the applications of this technique to the chest disease summarising its clinical impact on the assessment of lung and airways diseases, mediastinal abnormalities (excluding vascular disorders which are covered elsewhere), and in the evaluation of lung cancer patients. The impact of spiral CT on the non-invasive detection of pulmonary thrombo-embolic disease is also considered.