Background It is a well known that higher levels of serum calcium, phosphate, and calcium phosphate product (CPP) are associated with higher rates of coronary artery disease (CAD) in patients with advanced chronic kidney disease (CKD), but whether this relationship would extend to individuals with normal kidney function is not well elucidated. We explore an association between serum calcium, phosphate and CPP and coronary atherosclerosis, using non-invasive coronary CT angiography (cCTA) in subjects with near-normal kidney function. Methods We consecutively enrolled 7697 subjects (52 짹 10 years, male 57%) who underwent cCTA for the evaluation of suspected coronary artery disease (CAD) and had estimated near normal kidney function (estimated glomerular filteration rates (eGFR) >60ml/min/1.73m2). Serum calcium, phosphate and CPP was studied in relation to the extent and severity of CAD by cCTA, considering coronary artery calcium score (CACS), the presence of any CAD as well as the presence of obstructive CAD (���50% diameter stenosis). Results The prevalence of CACS>100, the presence of any CAD and obstructive CAD significantly increased with increasing quartiles of serum calcium, but not phosphate and CPP. (Figure) In univariate analyses, CACS>100, the presence of any CAD and obstructive CAD were also correlated with conventional risk factors, proteinuria and serum calcium, but not phosphate and CPP. In multivariable analyses, after adjusting for confounding variables, a higher quartiles of serum calcium was significantly associated with CACS>100, CAD and obstructive CAD (odd ratio (OR): 1.19, p=0.033; OR: 1.207, p<0.001; OR: 1.538, p<0.001, respectively). However, neither serum phosphate nor CPP correlated with them. Conclusion Higher serum calcium level, even in physiologic range is an independent risk factor for CAD in subjects with near normal kidney function. However, unlike previous study results, phosphate and CPP are weakly associated with coronary atherosclerosis in this population.