Congenital anomalies involving termination of a coronary artery and a fistulous communication with any cardiac chamber, pulmonary artery/vein, superior vena cava, or coronary sinus are defined as coronary cameral fistulas. Multi-detector computed tomography (MDCT) angiography with electrocardiographic gating precisely demonstrates complex and multiple coronary fistulas, their course and drainage routes, and relationships with surrounding structures, and MDCT is the primary modality for diagnosis, pre-treatment planning, and follow up of coronary cameral fistulas. We report three cases involving two elderly adults and a three-year-old child who were suspected to have coronary cameral fistulas and underwent MDCT to confirm the diagnosis and delineate the fistula, emphasising the unique role of MDCT in their diagnosis and management, along with a review of the literature.