Photon-counting CT (PCCT) uses semiconductor detectors to directly convert X-ray photons to electrical signals, the intensity of which is directly proportional to the energy of the individual photons. PCCT offers several advantages in cardiovascular imaging, including ultra-high-resolution (UHR) imaging, improved multi-energy capabilities, reduced noise and artifacts, and improved iodine signal and radiation dose efficiencies. UHR imaging enhances the assessment of small vessels, dense calcifications, and stents. Multienergy mode enhances the iodine signal, reduces artifacts, and allows for material separation and lesion characterization. In this article, we review PCCT technology, highlight the benefits of PCCT in cardiovascular imaging using case examples, and discuss its challenges.