PURPOSE: Coronary artery calcium scoring (CACS) is widely used to differentiate an asymptomatic individual at high risk. However, CACS only detect calcified plaque as a surrogate marker of coronary atherosclerosis, and the absence of calcified plaque alone dose not be enough to exclude future cardiac events. We, therefore, identify the subjects with exclusively noncalcified plaque (NCP) using coronary CT angiography (CCTA), and define their characteristics comparing to those with different types of plaque. METHODS: We consecutlvely enrolled 3818 asymptomatic subjects (49 짹 10 years, male 60%) free of known cardiovascular disease or symptom who had underwent both CACS and CCTA as a part of routine health check-up. Cardiovascular risk factors, CACS as a whole and presence of atherosclerotic plaque and significant stenosis (��� 50% diameter stenosis) for each coronary segment were determined. RESULTS: Atherosclerotic plaques were identified in 859 (22 %) subjects. 241(6%) subjects had exclusively NCP without CAC: 28 (11%) of those had significant stenosis. Most of them had single vessel disease (89%) and most (53%) of the significant lesions were located in the left anterior descending coronary artery . Comparing to subjects with different types of plaque, those with exclusively NCPs were characterized by younger age (p<0.001), and lower total cholesterol (p=0.015) and LDL-cholesterol (p=0.015) as well as less diabetes mellitus (p=0.044), hypertension (p<0.001), renal insufficiency (MDRD GFR < 60ml/min/1.73m2 ,p=0.003). However after adjusting conventional risk factors, there were significant difference only in age and incidence of hypertension. CONCLUSIONS: Our study demonstrated that incidence and severity of exclusive NCPs are not negligible. Although current screening method guided by CACS could detect calcified plaques efficiently in asymptomatic subjects, it can miss NCPs which can elicit future cardiac events. Screening of subclinical coronary atherosclerosis using CCTA could be considered as an alternative especially in young, hypertensive subjects.