Abstract: Objective To investigate the use of coronary CT angiography (CCTA) in determining the characteristics of plaques and predicting the progress of coronary artery disease (CAD). Methods CAD patients who were admitted to Department of Cardiology, the 71th Hospital of PLA (the Affiliated Huai'hai Hospital of Xuzhou Medical University) from January 2016 to January 2019 were enrolled and their clinical data were retrospectively analyzed. A total of 60 patients with 112 plaques, who suffered from acute myocardial infarction (AMI), underwent percutaneous coronary intervention (PCI), or who were diagnosed with severe stenosis by CCTA, and diagnosed with non-obstructive CAD within two to five years by CCTA, were set as a progress group. Meanwhile, another non-obstructive CAD 50 patients with 78 plaques, who underwent CCTA for consecutive twice (with a scanning interval ≥2 years) were selected as a control group. Both groups were compared for the characteristics of their plaques, including plaque volume, plaque burden, the risk of plaque and calcification. Results Compared with the control group, the progression group showed no statistical differences in age, gender, body mass index (BMI), smoking, and the use of statins (P＞0.05), with a increased proportion of patients with diabetes (P＜0.05). According to the qualitative and quantitative evaluation results of plaques by CCTA, the progress group presented remarkable increases in plaque burden, plaque volume and the proportion of high-risk plaques (HRP), compared with the control group (P＜0.05). The presence of HRP and plaque burden by CCTA were the independent factors affecting the progression of CAD (P＜0.05). Conclusions High plaque burden and HRP found by CCTA are associated with the progress of CAD. The characteristics of CAD by CCTA is valuable to predict the progress of the disease.