Aim of the work: Noninvasive assessment of the prevalence of coronary heart diseases and coronary artery calcification in patients with asymptomatic metabolic syndrome. Patients and method: The study is carried out in cardiology department, faculty of medicine, Zagazig university hospitals it includes 240 asymptomatic patients with metabolic syndrome, all patients were subjected to, history taking, clinical examination, Waist circumference measurement, Body mass index, twelve leads ECG, Laboratory investigations: and measuring calcium score using multislice coronary CT according to the Agatson scale. Results: In this study there was no statistical significance association between diabetes mellitus, hypertension, and triglycerides levels and the extent of coronary artery calcification, while there was statistically significant association between coronary artery calcification and reduced HDL, and increased waist circumference. Conclusion: Coronary artery calcification screening is an accurate and valuable method for detecting atherosclerotic burden in patients with metabolic syndrome