Pericoronary adipose tissue(PCAT) is the fat deposit surrounding coronary arteries. Although PCATis part of the largerepicardial adipose tissue (EAT) depot, it has different pathophysiological features and roles in the atherosclerosis process.While EAT evaluation has been studied for years, PCAT evaluationis a relatively new concept. PCAT, especially the mean attenuationderived from CT imagesmay be used to evaluate the inflammatory status of coronary arteries non-invasively.The most commonly used measure, PCATMA, is the mean attenuation of adipose tissue of 3 mm thickness around the proximal RCA with a length of 40 mm. PCATMAcan be analyzed on a per-lesion, per-vessel or per-patient basis. Apart from PCATMA, other measures for PCAT have been studied, such asthickness, and volume.Studies have shown associations between PCATMAandanatomicaland functional severity of CAD. PCATMA is associated withplaque components and high-risk plaque features,and can discriminate patients with flow obstructing stenosis and myocardial infarction.Whether PCATMAhas value on an individual patient basis remains to be determined. Furthermore, CT imagingsettings, such as kV levelsand clinical factors such as age and sex affect PCATMAmeasurements, whichcomplicate implementation in clinical practice. For PCATMAto be widely implemented, a standardized methodologyis needed. This review gives an overview of reported PCATmethodologies used in current literature and the potential use cases in clinical practice.