This guide will help medicolegal death investigation agencies that are considering adopting postmortem computed tomography (PMCT) make informed decisions. First, the basic questions are outlined that must be considered before approaching architects or gathering information about specific CT scanners. Next, the evolution of PMCT use at the New Mexico Office of the Medical Investigator is described as just one example of how a PMCT service can function in a high-volume agency. The remainder of the guide covers, topic-by-topic, important considerations for planning, establishing, and maintaining a PMCT service in a medical examiner's or coroner’s office. In presenting this information, specific vendors are not named or endorsed, CT scanner models, or commercial software products—in part, because new products are continually available, and specific recommendations would quickly become outdated. Furthermore, because of the ubiquitous use of CT in clinical medicine, there are many reputable vendors with a range of products and services from which to choose. Given the variety of death investigation agencies (e.g., large, small, medical examiner, coroner) and the variation in the imaging technologies already available at each agency (portable X-ray, whole body X-ray), there is neither a single CT scanner nor image viewing software package that will be the best fit for every agency. For agencies that are already considering adding PMCT to their death investigation toolbox, this guide aims to provide practical guidance from a technical and operational perspective. Basic PMCT concepts and terminology, functions and features, general operational questions to consider, and potential issues are outlined to help agencies confidently gather sufficient information and spur the fruitful discussions required to make informed decisions about PMCT.