Background: We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary artery remodeling pattern and plaque components in 1,133 patients. Methods: We divided the patients into two groups according to the remodeling pattern as positive remodeling (PR, remodeling index >1.05) group (n=192) and intermediate remodeling (IR, remodeling index <1.05 and >0.95)/negative remodeling (NR, remodeling index <0.95) (n=941). VH-IVUS analysis classified the color-coded tissue into four major components: green (fibrotic, FT); yellow-green (fibro-fatty); white (dense calcium); and red (necrotic core, NC). Thin-cap fibroatheroma (TCFA) was defined as focal, NC-rich (��� 10% of the cross-sectional area) plaques being in contact with the lumen in a plaque burden ��� 40%. Results: PR group was older had higher white blood cell count (8248짹2802 vs. 7241짹2411/mm3, p=0.032) and lower hemoglobin level (13.1짹1.6 vs. 13.5짹1.6 mg/dl, p=0.039) compared with IR/NR group. PR group had greater plaque plus media area at the minimum lumen site (12.8짹4.9 vs. 9.9짹3.8 mm2, p<0.001) and smaller %FT area at the minimum lumen site (57.0짹14.5 vs. 59.4짹14.6%, p=0.037) and greater %NC area at the minimum lumen site (21.7짹12.3 vs. 18.2짹11.6%, p<0.001) compared with IR/NR group. PR group had greater plaque volume (188짹150 vs. 135짹130 mm3, p<0.001) and smaller %FT volume (58.3짹11.7 vs. 60.6짹11.0%, p=0.009) and greater %NC volume (19.1짹9.6 vs. 16.6짹9.2%, p=0.001) compared with IR/NR group. PR group had more TCFA compared with IR/NR group (21% vs. 13%, p=0.006). Conclusions: VH-IVUS analysis demonstrates that PR was associated with more vulnerable plaque component compared with IR/NR. Key Words: Remodeling, Plaque, Intravascular Ultrasound