Computed tomography (CT) examinations account for a significant portion of individuals' increasing exposure to medical radiation. Automatic exposure control (AEC) was introduced in CT scanners to decrease patient doses while maintaining appropriate image quality.To identify areas for AEC optimization and suggest practical optimization methods.A literature review was conducted to assess current knowledge regarding tube current modulation and AEC in CT from peer-reviewed journals and publications from national and international organizations involved in medical imaging and radiation protection.Four important aspects of AEC use were identified: interaction of user-selectable parameters with AEC, patient positioning and AEC, specific challenges with patient size groups and how to select appropriate input value.AEC is a useful tool for dose optimization but dose savings are not guaranteed unless the equipment is used properly. Further research is required into optimal use of AEC, particularly for pediatric examinations.