A general expression is derived for the noise due to photon counting statistics in computed X-ray tomography. The variance is inversely proportional to the cube of the resolution distance. For scanners using a water box, the noise in the reconstructed image depends inversely on the number of detected primary photons, summed over all angles, that have passed through a resolution element. Predictions of this formula agree well with the results of computer simulations. It is shown how this formula can be used to determine such parameters as required X-ray flux, detector counting rate, and dose, with special emphasis on tradeoffs between these parameters and resolution. It is also shown that to determine the X-ray attenuation coefficient of a resolution element to a given precision, the number of photons required by computed X-ray tomography is close to a theoretical limit.