Background: This study aimed to explore the application of 270 mg l/mL iodinated contrast agent with a tube voltage of 100 kV scanning in coronary computed tomography angiography (CCTA). Methods: This CCTA study was a prospective observational study. The two radiologists were blinded to both patient information and image date arrangement. One-hundred twenty patients (body mass index < 25.0 kg/m(2)) were randomly divided into three groups based on contrast agent concentrations of 370, 320, and 270 mg l/mL, scanning at an injection rate of 5 ml/s. Then, the coronary artery branches of the three groups were compared, and the display rate, mean computed tomography (CT) value, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image noise, and radiation dose were analyzed. Results: The artery display rates of the four main branches of coronaries in the three groups were all 100%, and the difference in the display rates of the remaining small branches in the three groups exhibited no statistical significance (p > 0.05). A comparison of the mean CT value of the coronary artery of three groups in the ascending aorta, descending aorta, left main, left ventricular wall, right coronary artery, left anterior descending, and left circumflex showed a statistically significant difference (p < 0.05). A comparison of the SNR, CNR, image noise, and radiation dose showed no statistically significant difference (p > 0.05). Conclusions: Using a tube voltage of 100 kV combined with 270 mg l/mL iodinated contrast media in CCTA examination can achieve the "double low dose" effect while ensuring image quality.