Abstract: Pericoronary adipose tissue (PCAT) is a type of adipose tissue tightly wrapped in the adventitia of the coronary artery, which communicates bidirectionally with the coronary artery wall and promotes the development of coronary atherosclerosis during vascular inflammation. PCAT based on coronary computed tomography angiography can extract quantitative features from images with high throughput, hence has better diagnostic efficacy for analyzing plaque composition and identifying vulnerable plaques, predicting coronary artery and hemodynamic stenosis, and identifying and predicting acute coronary syndrome. This paper reviewed the research progress of PCAT based on CCTA in coronary atherosclerosis.