OBJECTIVE. The purpose of this study is to retrospectively measure and compare estimated radiation doses between consecutive patient cohorts who underwent coronary imaging CT with 64- and 320-MDCT scanners. MATERIALS AND METHODS. Subjects without arrhythmia (n = 4475) underwent imaging with 64-MDCT (n = 770) and 320-MDCT (n = 3705) scanners and were classified into one of five subgroups according to the patient heart rate and the image acquisition strategy. For all patients, image quality was subjectively evaluated using a 3-point scale. Estimated radiation dose and image quality were compared between subjects stratified by CT scanner and by subgroups imaged with each technology. RESULTS. For patients with a heart rate of 60 beats/min or less, the estimated radiation dose was halved (3.8 ± 2.0 vs 7.6 ± 2.6 mSv) when the 320-MDCT scanner (n = 2787) replaced the 64-MDCT scanner (n = 511). For the entire cohort, image quality score was significantly better (2.9 ± 0.4 vs 2.8 ± 0.5; p < 0.0001) and the effective dose was significantly lower (4.9 ± 3.3 vs 9.9 ± 5.4 mSv; p < 0.0001) for 320-MDCT scanners, compared with 64-MDCT scanners. CONCLUSION. Wide area-detector coronary CT angiography protocols have reduced radiation dose, with image quality maintained at the same level, compared with 64-MDCT technologies.