Objective To compare the image qualities of low tube voltage renal artery computed tomography angiography (CTA) using adaptive iterative dose reduction (AIDR) and filter back projection (FBP) algorithm, and evaluate the clinical application value of AIDR. Mehtods Twenty consecutive patients underwent renal artery CTA. The collected raw data were reconstructed by ADIR and FBP algorithm respectively. CT and background SD value of abdominal arota, renal artery and erector muscle of spine were measured, the SNR and CNR were calculated, and the image quality were compared with subjective grading. Results In subjective evaluation of the image quality as a whole and blood vessel sharpness, the AIDR group was higher than that in FBP group. There were no significant differences in the vessel branches displayed on MRP, VR and MIP. For objective evaluation, there were no significant differences of the CT value of abdominal arota, renal artery and erector muscle of spine between two groups. The SNR and CNR in AIDR group were higher than that in FBP group, the SD values were lower than that in FBP group. Conclusion The image quality of AIDR group was better than that of FBP. AIDR could reduce the imaging noise, improve the image quality and has the potential of radiation reduction.