Background: Chest computed tomography (CT) is an excellent screening tool for blunt aortic injuries (BAIs). Aortography is considered the "gold standard" for diagnosis. Recent evidence suggests that new-generation, multislice, helical CT technology can accurately diagnose BAI. Methods: A retrospective review of aortograms performed to evaluate for BAI was compared with the results of CT and operative findings. BAIs definitively diagnosed by CT alone were also studied. Results: Between July 1, 1996, and June 30, 2002, 113 aortograms were obtained, with 28 BAI cases confirmed. Of these, 27 were congruently diagnosed by CT. Only one computed tomographic scan diagnostic for BAI had a subsequent negative aortogram. Seventeen BAIs were diagnosed with CT alone. Ten were confirmed operatively and seven were treated nonoperatively because of age, comorbid conditions, severity of injury, or the presence of small intimal defects. Conclusion: CT technology has evolved to allow for the definitive diagnosis and treatment of BAI. Aortography should still be used where new-generation CT is not available.