While coronary computed tomography angiography offers a noninvasive method to identify the presence or absence of coronary artery disease, the functional significance of anatomical lesions identified by this technique is often unknown. As a result, some patients may require further testing to assess for ischemia in order to help guide the need for further interventions. Recently, it has been recognized that cardiac CT is able to visualize rest and stress myocardial perfusion, thus enabling the possibility of evaluating the anatomical burden and physiological significance of coronary artery disease in a single exam. This article will provide an overview of CT perfusion and review the most recent developments relating to this new technique. The potential use of late enhancement imaging will also be discussed. Finally, an overview of the key research questions in this field will be presented followed by a discussion regarding the future direction of CT perfusion imaging.