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Purpose: In this paper a method for cardiac imaging with fast multi-slice CT and retrospectively ECG-gated spiral acquisition is presented., Methods: A fast multi-slice CT system with 4 simultaneously acquired slices and 0.5 s rotation time is used (Siemens Somatom VolumeZoom). Continuous spiral data of the entire heart volume is acquired together with the patient's ECG and reconstructed with dedicated spiral algorithms providing 250 ms temporal resolution. Three-dimensional image data sets are built up from overlapping slices that are reconstructed in an arbitrary, user-defined phase of the heart cycle (e.g. diastolic phase). To evaluate the capability of the method for functional imaging complete three-dimensional image volumes are reconstructed from the same spiral data set in different phases of the heart cycle., Results: A spiral data set of the entire heart volume may be acquired within a single breath-hold. Typical scan times for standard examinations with 3 mm slice width are 10-15 s, and for high-resolution CT angiographies of the coronary arteries with 1.25 mm slice width about 30-35 s. Motion-free reconstruction of the heart and coronary arteries with high spatial resolution is possible in the diastolic phase of the heart cycle. Multi-phase reconstructions from the same spiral scan data set are possible, however, motion artifacts in heart phases with fast cardiac motion may not be completely avoided., Conclusion: Fast multi-slice spiral CT with retrospectively ECG-gated spiral reconstruction is well suited for three-dimensional and functional imaging of the heart, especially for high-resolution imaging of calcified coronary plaques and CT-angiography of the coronary arteries.