The last generations of Multi Detector Row CT (MDCT) have revolutionized the management of chest disease. This is especially obvious for airway and lung parenchyma evaluation. MDCT allows volumetric high resolution scanning with isotropic resolution. Thus, contiguous visualization of the lung parenchyma is achieved. The resulting high quality 2D and 3D reconstructions enable a significant improvement in the diagnostic approach. Since the lung parenchyma has a unique natural contrast, low and even ultra-low radiation dose scanning protocols may be used in routine practice. In all cases, a good signal to noise ratio has to be maintained combined with the best possible spatial resolution, allowing all types of reconstructions.