This study was conducted to determine whether the amount of local pericoronary fat volume is associated with the presence of plaque burden in the underlying coronary artery segment. For that purpose, 311 patients who underwent dual-source computed tomography for potential coronary artery disease were included in the study cohort. A positive association was found between pericoronary fat volume and the presence of plaque, independent of overall pericardial fat volume as well as of traditional risk factors. Moreover, associations were observed in both calcified and non-calcified plaques. These results suggest that perivascular fat depots may have a local role in atherosclerosis development.