Ventricular tachycardia (VT) portends high morbidity and mortality in cardiac sarcoidosis (CS). Left ventricular scarring in CS is often patchy with a predilection for the basal septum, anterior wall, and perivalvular regions. Reliable pre-procedural imaging modalities as adjuvant tools for VT scar localization are limited. To assess anatomic correlation of late iodine enhancement with procedural scar localization and to determine whether such correlation predicts ablation success. Consecutive VT ablation procedures from January 2017 to December 2020 at the Medical University of South Carolina were retrospectively reviewed. Thirteen patients with CS underwent pre-procedural computed tomography (CT) to identify wall thinning (WT) and late iodine enhancement (LIE). Left ventricular scarring was confirmed with voltage mapping and classified based on anatomical region: LV ostium, anterior, septal, inferior, lateral, and apical. Fisher's exact probability extension for 2 x 2 contingency tables were used to test whether there was significant congruency of two modalities. The cohort included 13 patients with CS (92% male, 60 +/- 11 years, EF 40.9% +/- 12.5). Average procedure time was 279 +/- 89 minutes with > 1 inducible VT per case (8 LBBB, 6 RBBB; average CL 414 ms) in all patients. The presence of WT did not correlate with LIE at the LV ostium (p=0.19) but did with anterior (p=0.007), inferior (p=0.005), and lateral (p=0.005) regions. WT was not associated with scar localization. The presence of LIE demonstrated convergence with scar localization at the LV ostium (p=0.005). Of 6 patients with normal wall thickness and positive LIE at the LV ostium (i.e. discordance), 5 (83%) had noninducible VT substrate post-ablation. Of those 5 patients, 3 (60%) had arrhythmia recurrence and required repeat ablation. In patients with cardiac sarcoidosis, LIE on CT correlates with scar localization at the LV summit. Ablation of LIE-identified LV ostial scars yields a high rate of acute success in patients with CS. Future studies should investigate the association between WT-LIE-scar localization and long-term outcomes.