OBJECTIVES: To show the recent improvements in CT imaging of the trachea due to the introduction of multidetector computed tomography (MDCT). MATERIAL AND METHODS: MDCT technology, which was introduced in the early 00's, allows acquiring the entire airways within few seconds while using low dose parameters thanks to the natural high contrast of the airways. RESULTS: Volume acquisition with isotropic voxels offers an excellent anatomical resolution in all directions, improving the quality of multiplanar reformations and 3D reconstructions, including virtual bronchoscopy. Therefore, the ability of CT for detecting and localizing tracheal abnormalities are improved, which is useful for planning endoscopy or open surgery, or assess their results. Dynamic acquisition during expiration is the last refinement permitted by MDCT, which is of value to detect tracheomalacia. CONCLUSIONS: MDCT is a non-invasive technique to image the trachea. Its applications are numerous, such as depiction of anatomical or functional abnormalities, evaluation of local extent of the disease, planning and assessing open surgery or interventional endoscopy.