Coronary computed tomography angiography (CCTA) offers excellent negative predictive value for coronary artery disease (CAD). In suspected single-vessel disease, invasive coronary angiography (ICA) could be simplified by deferring visualization of the normal coronary artery as identified on CCTA. This ultraselective ICA strategy might reduce procedure time, contrast use, and radiation exposure. This prospective study evaluated the potential benefits of this strategy.