Coronary artery calcification has long been known to be associated with atherosclerosis and is intimately associated with atherosclerotic plaque development. Similarly, aortic valve degeneration and calcification appears to follow a pathophysiologic process very similar to atherosclerosis. Newer noninvasive technologies such as Electron Beam Tomography (EBT) allow the practicing physician to accurately detect and quantify cardiovascular calcification. It has recently become apparent that coronary calcium is an excellent marker of risk for myocardial infarction and sudden death in an individual patient and that aortic valve sclerosis is associated with high risk of coronary events. Besides identification and quantification of cardiovascular calcification, the EBT technology has also been employed to accurately measure the rate of progression of coronary calcification and it could become a very helpful tool to gauge effectiveness of therapy instituted to halt the progression of atherosclerosis. In this article we present a review of the studies published to date on the use of EBT imaging to gauge the effects of medical therapy on coronary and valvular calcification.