PURPOSE: To delineate complex plaque morphology in patients with stable angina using coronary computed tomographic angiography (CTA). MATERIALS AND METHODS: 36 patients with complex plaques proven by conventional coronary angiography (CAG), who had taken CTA for evaluation of typical angina, were enrolled in this study. Intravascular ultrasonography (IVUS) was performed in 14 patients (16 lesions). We compared CTA with CAG for plaque features and analyzed vascular cutoff, intraluminal filling defect in a patent vessel, irregularity of plaque, and ulceration. Also, the density of plaque was evaluated on CTA. RESULTS: CAG and CTA showed complex morphology in 44 cases (100%) and 34 cases, (77%), respectively, with features including abrupt vessel cutoff (27 vs. 16%, kappa= 0.57), intraluminal filling defect (32 vs. 30%, kappa= 0.77), irregularity (75 vs. 52%, kappa= 0.52), and ulceration (16 vs. 11%, kappa= 0.60). CTA indicated that the complex lesions were hypodense (mean = 66 +/- 21 Houndsfield Units). CONCLUSION: CTA is a very accurate and useful non-invasive imaging modality for evaluating complex plaque in patients with typical angina.