Coronary computed tomography angiography (CCTA) has emerged as an important tool for planning percutaneous coronary intervention (PCI). While it has traditionally been employed for diagnostic purposes, increasing evidence and real-world experience suggest that CCTA can be used for the preprocedural planning of PCI and can inform patient triage, shared decision making, case complexity, and resource use. This approach mirrors how computed tomography angiography is routinely used to plan structural interventions. To address these emerging opportunities, the Society for Cardiovascular Angiography & Interventions (SCAI) and the Society of Cardiovascular Computed Tomography (SCCT) organized a multidisciplinary, expert scientific roundtable on the use of CCTA for guiding PCI. In this Clinical Conversation the authors highlight the expert opinion, published in JSCAI. The document provides a state-of-the-art overview of CCTA-guided PCI focused on practical applications and key coronary lesion subsets, define unmet needs and barriers, and outline future directions