Abstract: As a non-invasive functional radiographic imaging method, perfusion computed tomography (PCT) permits the evaluation of non-small-cell lung cancer (NSCLC) angiogenesis and response to therapy by demonstrating alterations in NSCLC vascularity. PCT performed shortly after initiating therapy may provide a better evaluation of physiological changes rather than conventional size assessment obtained by response evaluation criteria in solid tumors. Based on the angiogenesis principle of NSCLC, the main evaluation indexes of PCT are blood flow, blood volume, mean transit time, permeability surface, and peak enhancement index. The relationship between PCT and the indexes of "vascular normalization" may have implications for exploring the predictive model of efficacy and prognostic factors of NSCLC. The cavity of microvessel in NSCLC and expression of VEGF factors are closely related to PCT imaging. According to PCT assessment, pathological classification and histological type of NSCLC play significant roles. However, technical limitations, reproducibility of blood flow parameters, radiation dose, and volume of contrast medium delivered to the patient are some issues in this type of investigation. With the development of PCT technology and anti-angiogenesis drugs for NSCLC, more molecular imaging markers and standardized targeted therapies will be available. Such advancements will provide a wider space for the assessment of NSCLC treated with anti-angiogenic therapy using PCT.