BACKGROUND: Depression is associated with coronary artery disease, and atherosclerosis seems to play a central role in this relation. In several studies, multislice computed tomography (CT) has been applied for detection and quantification of coronary artery calcification (CAC) in relation to depression. To our knowledge, only one previous study has investigated the relation between CAC and depression in an unselected population. METHODS: A total of 617 persons were randomly selected from the background population. The participants underwent CT of the heart and were screened for depression by use of the Major Depression Inventory questionnaire. Quantification of CAC was performed using the Agatston method. The Mann-Whitney U test, Spearman's correlational analysis, and logistic regression were used to assess the association between depression and CAC. RESULTS: The median Agatston score was not significantly different in subjects with depression than in those without depression (p = 0.783), and depression scores did not correlate significantly with Agatston scores (r = 0.023; 95% CI: -0.056-0.102; p = 0.573). This was also the case when correlational analyses were stratified by sex or age. Furthermore, after the exclusion of an outlier, no significant association between CAC and depression was found in either the unadjusted or adjusted logistic regression model, OR = 1.00 (95% CI: 0.88-1.14; p = 0.994) and OR = 1.04 (95% CI: 0.92-1.18; p = 0.529), respectively. CONCLUSIONS: Depression was not associated with CAC in an unselected middle-aged population, although a trend-level association was found in men (p = 0.086).