The use of imaging in both hospital and non-hospital settings has expanded to more than 70 million CT procedures in the United States per year, with nearly 10% of procedures performed on children. The availability of multiple-row detector CT (MDCT) systems has played a large part in the wider usage of CT. This rapid increase in CT utilization combined with an increasing concern with regard to radiation exposure and associated risk demands the need for optimization of MDCT protocols. This manuscript will briefly discuss how technology has changed in regard to MDCT protocols, helping to reduce radiation dose in CT, especially in pediatric imaging.