BACKGROUND Calcification of the aortic wall has been used as an index of the degree of complicated atherosclerotic plaque formation. Atherosclerosis in the abdominal aorta in patients with abdominal aortic aneurysm (AAA) was studied by measuring aortic calcification via computerised tomography. METHODS METHODS retrospective study. METHODS preoperative computer tomography (CT) in 129 male patients with a mean age of 68.6 years (range: 42 to 82) undergoing elective aneurysmectomy. METHODS a conventional CT scanner was used. Aortic calcification was assessed at four levels: (A) the origin of the coeliac artery, (B) the left renal vein, (C) the maximum diameter of the aneurysm, and (D) the aortic bifurcation. Calcification was graded as: (0) no calcification, (1) calcification less than 40% of the aortic circumference, or (2) calcification more than 40% of the aortic circumference. The relationships between aortic calcification at each level and various factors related to atherosclerosis were analysed. RESULTS Maximum calcification was seen at level D, followed by levels C, B and A, in that order. Calcification was less common in patients younger than 50 years old. Hypertension, coronary artery disease, and peripheral vascular occlusive disease correlated with the incidence of aortic calcification. CONCLUSIONS A correlation between aortic calcification and atherosclerotic disease was demonstrated in patients with abdominal aortic aneurysm.