Backgrounds: While substantial studies have suggested the association between osteoporosis and coronary calcification, and, possibly, atherosclerosis, it is still unknown whether their association may be an epiphenomenon related to reduced estradiol (E2) levels. The aim of this study is to evaluate the association of bone mineral density (BMD) or E2 and coronary artery disease in asymptomatic individuals. Methods: From January 2009 to March 2011, 2346 subjects who received routine health checkup at Seoul St. Mary���s Hospital and underwent multidetector coronary computed tomography (MDCT) were enrolled. Coronary artery disease was evaluated by Gensini score, atheroma burden score (ABS) and coronary calcification score (CCS, Agaston score) measured in MDCT. BMD was measured with dual X-ray absorptiometry(DXA). Serum E2 levels were checked in females. . Results: BMD did not correlate to Gensini score, ABS or CCS in entire subjects, but Gensini score or CCS showed positive correlation (r= 0.672, p= <0.001). In female group, positive correlation was noted between BMD and coronary calcification (r= 0.288, p=<0.001 at Femur total), and negative correlation between BMD and Gensini score (r= -0.102, p= 0.019 at Femur total). E2 was positively correlated with BMD (r= 0.288, p= at Femur total), and negatively correlated with CCS (r= -0.173, p= 0.001) and Gensini score (r= -0.107, p= 0.037) After adjusting covariate, E2 levels but not BMD was independently associated with CAD. Conclusion: Reduced estradiol levels were independently associated with coronary calcification and atherosclerosis in women. Reduced BMD was not related to the development of CAD.