OBJECTIVES: To show results of pediatric extremity multidetector computed tomographic (MDCT) angiography studies and to demonstrate diagnostic imaging findings in pediatric patients. METHODS: Multidetector computed tomographic angiography studies were performed in 20 patients using 16- and 64-row MDCT scanners. Three-dimensional volume-rendered and maximum-intensity projection images were obtained from axial images to display vascular structures. RESULTS: All MDCT examinations were technically satisfactory. Metallic implants were present in 3 patients, and angiographic examinations were diagnostic in these patients. Occlusion, stenosis, and pseudoaneurysm were diagnosed in patients with trauma (n = 10). Vascular invasion was diagnosed in 1 patient with osteosarcoma. Compared with pathologic examination results, the sensitivity and specificity of MDCT to detect vascular invasion (n = 3) were both 100%. Three patients with vascular malformation underwent computed tomographic angiography to assess vascular supply of vascular malformations. Computed tomographic angiography showed vascular anatomy in 2 patients with congenital anomalies before and after flap transposition and in 1 patient with suspected thoracic outlet syndrome. Computed tomographic angiography showed brachial artery occlusion in a patient with Blalock-Taussing shunt. CONCLUSIONS: Multidetector computed tomographic angiography is a noninvasive technique that could replace conventional angiography as the initial diagnostic study for vascular evaluation of extremities in pediatric patients.