Photon-counting detector (PCD) CT is an emerging technology that has shown tremendous progress in the last decade. Various types of PCD CT systems have been developed to investigate the benefits of this technology, which include reduced electronic noise, increased contrast-to-noise ratio with iodinated contrast material and radiation dose efficiency, reduced beam-hardening and metal artifacts, extremely high spatial resolution (33 line pairs per centimeter), simultaneous multienergy data acquisition, and the ability to image with and differentiate among multiple CT contrast agents. PCD technology is described and compared with conventional CT detector technology. With the use of a whole-body research PCD CT system as an example, PCD technology and its use for in vivo high-spatial-resolution multienergy CT imaging is discussed. The potential clinical applications, diagnostic benefits, and challenges associated with this technology are then discussed, and examples with phantom, animal, and patient studies are provided. ©RSNA, 2019.