Aim To analyze the incidence and influencing factors of coronary artery calcification (CAC) by low dose chest CT in asymptomatic middle-aged male patients, and to explore the value of low dose chest CT in early screening of cardiovascular diseases. Methods 2 571 asymptomatic male participants aged 40~65 were selected who underwent health examination at General Hospital of Eastern Theater Command from January to December 2022. General data, blood indicators, chest CT and other data were collected, and participants were divided into CAC group (n＝422) and non-CAC group (n＝2 149) according to whether chest CT indicated CAC. The differences between the two groups and the risk factors of CAC were analyzed. Results Among 2 571 asymptomatic middle-aged male patients, the positive rate of CAC was 16.41%. The age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, pulse, waist circumference, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), triglycerides (TG), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) were higher in CAC group than in non-CAC group, and the red blood cell count (RBC) was lower in CAC group than that in non-CAC group (all P＜0.05). Univariate Logistic regression analysis showed that the effects of age, BMI, systolic blood pressure, diastolic blood pressure, pulse, waist circumference, RBC, ALT, AST, BUN, TG, FBG, and HbA1c on CAC were statistically significant (all P＜0.05). Multivariate Logistic regression analysis showed that age, BMI, diastolic blood pressure, RBC, and AST were independent risk factors for CAC (all P＜0.05). Conclusion Age, BMI, diastolic blood pressure, RBC, and AST are independent risk factors for CAC in low dose chest CT, and physical examination chest CT is valuable in cardiovascular disease screening.