Cardiovascular disease is the leading cause of death in the United States and worldwide. Despite major advances in the treatment of acute myocardial infarction, enhanced prevention of ischemic heart disease remains critical to improving the health of individuals and communities. The computed tomographic coronary artery calcium score is an established imaging biomarker that identifies the presence and amount of coronary atherosclerosis in an individual and their future risk for clinical cardiovascular disease and premature cardiovascular death. This article describes the process of performing a computed tomography scan for coronary artery calcium, quantifying the score and interpreting the results.