To assess the feasibility of detecting coronary arteries through high-pitch dual-source computed tomography (DSCT) thoracoabdominal angiography when using low-concentration contrast medium, low tube voltage, and iterative reconstruction. One hundred patients undergoing DSCT angiography with high-pitch data acquisition mode were prospectively enrolled in this study. Fifty patients were assigned to receive lodixanol 270 and scanned using the low tube voltage (100 kVp) technique and iterative reconstruction, while another fifty patients were assigned to lopamidol 370 and scanned under the conventional tube voltage (120 kVp) with the images were reconstructed with filtered back projection. Both subjective and objective assessment of image quality was performed and compared between the two groups by measuring the image noise, signal-to-noise ratio and contrast-to-noise ratio in the coronary arteries. Diagnostic images were obtained for 1267 of the 1325 segments (95.6%). No significant differences in image quality were found between patients given lodixanol 270 and lopamidol 370. The effective dose and contrast medium dose were 4.4 +/- 0.5 mSv and 6.7 +/- 0.6 mSv, 20.36 +/- 2.65 g and 28 +/- 1.98 g, corresponding to the lodixanol 270 and lopamidol 370 groups, respectively, with 34.3% dose reduction achieved in the low contrast medium lodixanol 270 group. High-pitch DSCT angiography of the thoracoabdominal aorta utilizing low iodine concentration contrast medium (lodixanol 270), low tube voltage, and iterative reconstruction is a feasible protocol with significant reduction in radiation dose and contrast medium, without compromising image quality.