Artificial intelligence (AI), and machine learning (ML) in particular, are rapidly transforming the world around us. In healthcare, AI/ML has the potential to improve every point in the clinical pathway. For cardiovascular computed tomography (CT) AI/ML could aid patient selection and screening, referrals and scheduling, image acquisition and reconstruction, image analysis and diagnosis, report generation, prognostication and risk stratification, management recommendations and follow-up. However, there are important challenges that must be considered for the development, assessment, and implementation of AI/ML to ensure that it is safe, reliable, cost effective, and improves outcomes for patients.