Coronary catheter Angiography (CA) regarded as the ‘‘Gold standard’’ for coronary arterial assessment is invasive and associated with morbidity and mortality. Alternatively, non–invasive coronary CT Angiography (cCTA) with the help of multislice CT (MSCT) is capable of acquiring motion–free, high–resolution images in a single breath hold. Our aim was to assess the accuracy of cCTA using single source 128 MSCT for evaluating coronary artery disease (CAD) compared to CA.  Thirty three patients with low to intermediate clinical suspicion were evaluated. CCTA showed a sensitivity, specificity, positive and negative predictive values of 100%, 93.3%, 94.7% and 100%respectively for detecting CAD. Two stenotic lesions with significant (>50%) diameter narrowing were missed by cCTA resulting in a sensitivity of 92.16% in the segment based analysis. The sensitivity for detecting non–significant lesions is 72.7%. Given the high sensitivity and negative predictive value, 128 MSCT can be effectively used to rule out significant CAD in patients with low to intermediate clinical suspicion.