Aim To investigate the relation of pericardial adipose tissue(PAT) volumes to risk factors,presence of coronary artery disease,and severity of coronary atherosclerosis.Methods 221 consecutive patients who underwent dual-source 64-slice CT and diagnostic coronary angiography were studied.Each subject was measured in waist circumference,body mass index(BMI),blood biochemical index and was estimated in cardiac parameters.PAT volume was determined by dual source CT.Coronary angiograms were analyzed for the diagnosis of coronary artery disease(CAD).Gensini score was used for assessment of severity of coronary atherosclerosis.Results PAT volume was significantly higher in men than that in women(241.44 ± 78.08 cm3 vs 216.46 ± 64.36 cm3,P=0.025).PAT volume in patients with CAD was significantly higher than that in patients without CAD(242.10±75.80 cm3 vs 189.23±52.26 cm3,P<0.001).Logistic regression analysis revealed that PAT volume (OR=1.11) and BMI (OR=1.01) were independent factors affecting the presence of CAD (P=0.001).PAT volume was significantly associated with the number of coronary arteries with ≥50% stenosis and Gensini score.Conclusion Elevated PAT volumes was significantly correlated with traditional risk factors for the development of cardiovascular disease,presence of coronary artery disease,and severity of coronary atherosclerosis.PAT volume may be a new index of assessing CAD risk and predicting the extent and activity of CAD.