Abstract: Objectives: To determine the prognostic value of coronary stenosis associated with regional ventricular motion abnormality by cardiac CT for predicting MACE(Major Adverse Cardiac Events, MACE) in patients with acute chest pain. Methods: 294 patients with acute chest pain were prospectively studied with a follow-up of 2 year for MACE, CT was assessed for the presence of plaque, stenosis(≥ 50% luminal narrowing), and RWMA(Left Ventricular Regional Wall Motion Abnormalities, RWMA). Kaplan-Meier method and COX risk models were made to evaluate the correlation between coronary artery stenosis(≥ 50%), left ventricular dysfunction and MACE. Results: MACE rate of patients with stenosis was 14 fold of those without. There was evident difference of MACE rate between patients with RWMA positive and those negative. The rate of MACE in patients without evident stenosis(＜ 50%) was 0.9%(RWMA negative) and 12.5%(RWMA positive), and 8.1%(RWMA negative) and 39.4%(RWMA positive) in those with stenosis(≥ 50). Conclusion: Besides providing coronary anatomical and functional information, CTCA can also predict the occurrence of MACE, with good clinical prognosis value in patients with acute chest pain.