The optimal pulsating cardiac phantom is an important tool for the evaluation of cardiac images and cardiac applications on ECG-gated MDCT. The purpose of this study was to demonstrate the design and fabrication of the pulsating cardiac coronary phantom. The newly developed pulsating cardiac coronary phantom has the following five key advantages: 1) a driver component that uses only one servomotor to move the phantom in three dimensions (X, Y, and Z directions) with 16 presets of different heart types (heartbeat: 0-120 bpm; ejection fraction: 0-90%); 2) versatile pumping and filling phases to simulate a real heart in a cardiac cycle can be incorporated into the driver sequence including shift of patient heartbeat or irregular pulse (maximum: 200 different heart waves in one scan); 3) a cardiac coronary component constituted of an acrylic/silicon/rubber tube (2-6 mm inner diameter) with stent/in-stent restenosis/stenosis/soft plaque/calcification parts and maximum 16 coronary arteries that can be attached to the phantom in the same scan; 4) the complete phantom can be submerged in a tank to simulate the heart and its surrounding tissues; 5) ECG gating can be from interior trigger and exterior trigger. It has been confirmed that the developed pulsating cardiac phantom is very useful to quantitatively assess imaging of the heart and coronary arteries during phantom experiments.