Coronary artery calcification (CAC) is as an independent risk predictor of cardiovascular disease and can classify an individual's risk of atherosclerotic cardiovascular disease, particularly in intermediate-risk individuals. Also, CAC progression is associated with greater rates of cardiovascular events. This article provides available data and expert recommendations for CAC based on current publications. We focus on the utility of CAC for stratification of individuals and describe its diagnostic value in identifying patients at risk. We also describe the important ability of CAC to derisk a patient with a score of zero.