Although there has been increasing recognition of the importance of reducing radiation dose when performing multidetector CT examinations, the increasing complexity of CT scanner technology, as well as confusion about the importance of many different CT scan parameters, has served as an impediment to radiologists seeking to create lower dose protocols. The authors seek to guide radiologists through the manipulation of 8 fundamental CT scan parameters that can be altered or optimized to reduce patient radiation dose, including detector configuration, tube current, tube potential, reconstruction algorithm, patient positioning, scan range, reconstructed slice thickness, and pitch. Although there is always an inherent trade-off between image quality or noise and patient radiation dose, in many cases, a reasoned manipulation of these 8 parameters can allow the safer imaging of patients (with lower dose) while preserving diagnostic image quality.