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Spectral computed tomography (CT) is an advanced imaging technique known for its ability to decompose and characterise materials. Understanding the underlying physics can aid radiologists in using the technique effectively, interpreting its imaging signs and identifying potential artifacts or limitations. In the field of thoracic radiology, it provides significant contributions to the diagnosis of vascular diseases such as acute and chronic pulmonary thromboembolism, in the follow-up of malignant pulmonary masses treated with percutaneous ablation, and it plays an emerging role in the characterisation of pulmonary tumours. The aims of this article are, firstly, to review the advantages and limitations of spectral imaging, and secondly, to discuss its applications in thoracic radiology.