Abstract: The occurrence of adverse cardiovascular events (ACE) is often due to vulnerable plaque rupture or thrombus formation on the basis of mild to moderate arteriostenosis. The research field for coronary artery disease has converted from the degree of luminal stenosis to the vulnerability of plaques. Therefore, exploring the mechanism of vulnerable plaque rupture, early identifying vulnerable plaques and preventing ACE have become the “hot spots” in the research field of cardiovascular diseases. In recent years, numerous studies have found that microcalcifications (μCalcs) are associated with plaque vulnerability, indicating that μCalcs may play an important role in plaque rupture. In this article we reviewed the relationship between microcalcifications and plaque vulnerability.