Objective To analyze the correlation between plasma homocysteine and coronary artery calcification. Methods A total of 329 patients undergoing coronary CT angiography were enrolled and grouped according to the coronary artery calcification score and the severity of coronary artery disease. The plasma homocysteine was measured, and an analysis was made of the correlation between homocysteine and coronary artery calcification. SPSS statistics 23.0 was used for statistical analysis, and depending on the type, data were analyzed using t test, analysis of variance, LSD test and χ² test. Results The concentration of homocysteine was higher in the calcification group than in the non-calcification group (P<0.05). In the calcificaton group, the homocysteine levels were (13.26±4.93)μmol/L in those with single lesion (n=53), (13.56±4.50)μmol/L in those with double lesions (n=63), and (14.49±4.16)μmol/L in those with multiple lesions (n=58), the difference being not statistically significant (F=1.915, P=0.151). Homocysteine concentrations increased with the increasing coronary artery calcification scores:(12.94±4.64)μmol/L in 1-99 group, (14.29±4.50)μmol/L in 100-399 group, (14.29±4.50)μmol/L in ≥400 group, the difference being statistically significant (F=3.581, P=0.030). The occurrence of coronary artery calcification was associated with the plasma homocysteine concentration (r=0.230,95%CI 0.150-0.349, P＜0.001). Conclusion Plasma homocysteine is related to the occurrence and severity of coronary artery calcification, suggesting that plasma homocysteine concentration may serve as a biomarker for coronary artery calcification.