Aim To evaluate the clinic value of coronary artery calcification (CAC) detected by EBCT in adult patients with valvular heart disease (VHD). Methods 208 patients including 110 men and 98 women with age ranging from 42～75 years. All patients underwent EBCT examination and coronary angiography within 1 week before surgery. An Imatron C-150 EBCT scanner with scanning protocol of ECG-triggered single-slice mode was used to detect coronary calcification .The quantitative study of coronary calcification was carried out by Agatston method. Selected coronary agiography was performed by the Judkins technique. The five classic risk factors of coronary artery disease (CAD) were analyzed including diabetes mellitus? hypertension? hyperlipemia? smoking and family history of CAD. Results In the 208 patients, no coronary calcification was found in 114 cases detected by EBCT. Among them, 109 cases had no CAD (95.6%, p<0.005) and only 5 cases associated with CAD confirmed by coronary angiography. In the five patients with CAD, 4 case had at least one CAD risk factor. In all of the 208 cases, 58 patients had neither CAC nor CAD risk factor. Among the 58 cases, only one patient had CAD demonstrated by coronary angiography (1.72%). Conclusions Based on this study, the adult patients with valvular heart disease have neither coronary calcification detected by EBCT nor CAD risk factor. The accuracy to exclude CAD is rather high, more than 95.6%. We recommend the patients with VHD taking EBCT examination to detect CAC before surgery, that will markedly reduce application of invasive coronary angiography.