Abstract Introduction: Prediabetes (pDM) is an extremely prevalent clinical entity which appears to be associated with an increased risk of cardiovascular (CV) disease. Coronary artery calcium (CAC) score has been shown to be a reliable risk predictor of CV disease too. The link between pDM and coronary CT (computed tomography) findings has not been explored yet. The present study aimed to investigate the association between CAC and pDM. Methods: The study cohort included 259 patients who underwent a coronary CT between July 2021 and July 2022 in our center. Prediabetes status was defined following the American Diabetes Association guidelines as HbA1c 5.7% to 6.4%. Significant CAC score was defined in ≥100 UA, as it is considered the common treatment threshold to iniate/consider statin. Results: 73 patients (28.2%) were classified as pDM. Compared with those with euglycemia, patients with pDM were older (59.91±12.44; 64.42±9.72 years, respectively). Hypertension (including systolic and diastolic blood pressure), dyslipidemia and smoking did not differ between both groups. After multivariate analysis, pDM was associated with significant CAC score (OR 2.08, CI 95% 1.02-4.28; p= 0.048). Conclusions: In our study, we found that prediabetes is associated with CAC score ≥100 UA. This association supports available evidence that pDM confers higher CV risk.