Coronary artery calcium (CAC) as measured by CT is a highly specific feature of coronary atherosclerosis and a great modality for early detection. CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major CV outcomes, especially when planning primary prevention interventions such as statins and aspirin. CAC testing in asymptomatic populations is cost-effective across a broad range of baseline risks and has been shown to positively impact patient compliance CAC testing CAC scoring may help improves risk stratification with an increase in primary prevention strategies.