The extent of coronary atherosclerosis,rather than the severity of stenosis,is the most important predictor of cardiovascular events.Coronary artery calcification(CAC)can quantify the atherosclerotic plaque burden.Therefore the CAC score has been confirmed to play a more important role in predicting the future cardiovascular events and mortality than the conventional cardiovascular risk factors,.Here is to review the relationship between CAC and atherosclerotic plaque burden,CAC testing and influencers,and its relationship with cardiovascular diseases.