Coronary angiography is the gold standard method for evaluation of the vascular lumen. It provides excellent results in demonstrating stenotic lesions of the coronary arteries. However, it is an invasive procedure which does not allow direct visualization and evaluation of the coronary artery wall. Today multislice computed tomography (MSCT) provides non-invasive estimation of the amount and extent of the coronary calcium. MSCT may be recommended as a screening tool in patients without symptoms of the coronary artery disease to identify individuals with high probability of its development. It is also useful for the differential diagnosis of the unclear chest pain, and for decision about feasibility of additional (including invasive) methods of examination. Coronary MSCT is fast, relatively inexpensive, patient-friendly and non-invasive modality for diagnosis of the coronary artery stenosis. It is progressively extending its application into all fields of cardiac disease. It was noted that the detection of the calcinates in the coronary arteries increases with age and often confirms the presence of the stenotic atherosclerotic plaques. Absence of calcium deposits is associated with low probability of hemodynamically significant stenoses of the coronary arteries and low risk of cardiovascular events in the next few years, but may occur in younger patients with atherosclerotic lesions.