Left ventricular (LV) function was shown to play a paramount role in the evaluation, management, and prognosis of patients with cardiac pathology. With the advent of multidetector computed tomography (MDCT), a novel tool for cardiac function assessment became available. This comes at no additional cost to the patient undergoing coronary CT angiography in terms of radiation exposure or contrast material delivery. The accuracy of LV function assessment by retrospective electrocardiographic gating intimately depends on the level of spatial and temporal resolution achievable during scanning. With the aid of today's fast-advancing technology, MDCT is now capable of acquiring data with isotropic submillimeter voxels that allow true 3-dimensional threshold-based chamber segmentation for accurate volumetric analysis. The challenge, however, continues to involve optimizing temporal resolution through various reconstruction techniques and technologic innovations. MDCT-determined global LV function variables were shown to strongly correlate with those of standard imaging methods. Regional function assessment has now become feasible with today's latest scanners. Its accuracy, however, still awaits a major breakthrough in temporal resolution to approach or possibly surpass that of echocardiography or magnetic resonance imaging.