CT colonography (CTC), also known as virtual colonoscopy, is a minimally invasive test for the detection of colorectal polyps and masses. At the authors’ institution, asymptomatic screening has been the overwhelming indication for CTC referral since local third-party coverage was initiated in April 2004. This practical review details the authors’ current approach to CTC screening, which has evolved and matured over time. It discusses the entire spectrum from program set-up through patient disposition following CTC examination. The authors hope this article will provide a roadmap for radiologists who wish to institute a CTC screening program.