Pre-procedural imaging is essential for successful planning and performance of several cardiac interventions. For this purpose, contrast-enhanced computed tomography (CT) imaging—owing to its high and isotropic spatial resolution as well as fast volume coverage—is gaining increasing importance. Cardiac CT offers high-resolution morphological and functional imaging of cardiac structures which is valuable for a variety of structural heart disease interventions, electrophysiology procedures, and coronary interventions. Over the last decade, the widened spectrum of transcatheter cardiac interventions has been associated with widespread acknowledgment that CT is particularly useful for pre-interventional imaging and increasing implementation in clinical routine. In this chapter, the role of cardiac CT for the guidance of coronary as well as non-coronary cardiac interventions is described.