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Background Coronary CT angiography (CTCA) is increasingly used first-line for investigation of coronary artery disease in the UK. This survey aimed to understand the current landscape of CTCA practices and procedures throughout the UK.Methods A cross-sectional electronic survey of 49 questions (mainly multiple-choice) was sent to BSCI/BSCCT members between November 2025 and February 2026.Results 79 responses were received from 63 centres (95% NHS; figure 1A). Most respondents were radiology (49%) or cardiology (28%) consultants. Annual CTCA volumes ranged from <200 to >3,000 (figure 1B). CTCA was commonly first-line for stable chest pain (82%) and graft assessment (67%), but less so for type 2 myocardial infarction (22%) and asymptomatic risk stratification (19%) (figure 2). CTCAs could be requested by ‘any healthcare professional’ at 56% of centres. Despite 62% performing coronary artery calcium scoring, 59% reported no calcium score threshold that would preclude CTCA. Siemens and Canon were the commonest scanner vendors (figure 3). Rate-limiting medications were predominantly given intravenously (56%), with 65bpm being the most common target threshold (44%) (figure 4). Sub-lingual or buccal GTN use was near-universal (97.7%). Radiographer-only lists operated in 28% of centres; of those without, 54% intended to introduce them, citing insufficient trained staff (29%) and Standard Operating Procedure/Patient Group Direction approval (23%) as the main barriers. CAD-RADS was used in all reports at 24% of centres, while 25% did not use it at all (figure 5).Conclusions Substantial variation exists in UK CTCA practice. These findings may help inform national standards and service improvement. Which of the following is the most commonly used threshold for administering rate-limiting medications before CT coronary angiography in the UK?A. 55bpmB. 60bpmC. 65bpm (correct)D. 70bpmAbstract 14 Figure 5Frequency of CADS-RADS reporting system usageAbstract 14 Figure 4Administration method for rate-limiting medicationsAbstract 14 Figure 3Frequency of scanner brands usedAbstract 14 Figure 2Frequency CTCA is first line for different indicationsAbstract 14 Figure 1Responding centre locations (A) and annual CTCA volumes per annum (B)E. 75pm