Computed Tomographic Renal Angiography (CTRA) has become an indispensable imaging modality in the preoperative evaluation of living kidney donors, providing detailed and accurate visualization of renal anatomy. Precise assessment of renal vasculature, including the number, branching patterns, and anomalies of renal arteries and veins, is crucial for donor selection and surgical planning to ensure optimal outcomes and minimize complications. This review highlights the pivotal role of CTRA in the preoperative evaluation process, emphasizing its advantages over other imaging modalities such as magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). With superior spatial resolution, rapid image acquisition, and widespread availability, CTRA enables comprehensive three-dimensional visualization of renal structures, assisting in the selection of the most suitable kidney for donation and enhancing the safety and efficacy of donor nephrectomy procedures. Technical considerations and diagnostic accuracy of CTRA are thoroughly discussed, along with potential limitations such as radiation exposure and risks associated with iodinated contrast agents. Innovations in imaging protocols, including low dose CT techniques and contrast-free imaging advancements, are explored as potential solutions to these challenges, aiming to further optimize donor safety. By synthesizing recent advancements and clinical evidence, this review underscores the critical role of CTRA in living donor evaluation and transplantation planning. Future directions, including the integration of emerging technologies and standardized imaging protocols, promise to refine the application of CTRA, ensuring improved outcomes for both donors and recipients in kidney transplantation.