The Multiethnic Study of Atherosclerosis (MESA) Study was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease in a population-based sample of 6,814 men and women aged 45-84 years at 6 clinical centers. Coronary artery calcium has been measured in serial exams using Electron-beam and multi-detector row computed tomography scanners. Since 2000, there have been 5 exams and participants have undergone cardiac scans at the 6 clinical centers. The CT Reading Center for cardiac scans in the MESA Study is at Los Angeles Biomedical Research Center. In this chapter we discuss technical parameters of the CT studies, prevalence of different incidental findings and our approach in evaluating and reporting these findings.