Objective: We sought to assess the significance of coronary artery anatomical variants and anomalies found in patients referred for coronary computed tomographic angiography (CTA). Methods: Imaging was done on a 128-detector computed tomography machine followed by three-dimensional reconstruction. Pre-and post-contrast angiographic images of the coronary arteries of 108 patients from January 2013 to December 2016 were retrospectively analysed for coronary artery anomalies and variants. Results: A total of 74 anomalies and variants were noted in 58 of 108 patients. Among variants, co-dominance, left dominant circulation, ramus intermedius, early origin of posterior descending artery (PDA), and double PDA were noted. Among anomalies, right coronary artery (RCA) origin from the ascending aorta and left coronary sinus, left circumflex artery (LCX) arising from the RCA, malignant course of RCA, retrograde aortic course of LCX, myocardial bridging, and coronary hypoplasia were noted. Conclusion: Prior assessment for coronary anomalies and variants can guide the interventionalist and surgeon before coronary angioplasty and coronary artery bypass grafting, thereby reducing procedural complications.