Objective To investigate the correlation between serum vasoactive polypeptide-12 (apelin-12) and coronary artery calcification （CAC）. Methods Totally 197 cases of patients, who were treated with coronary artery CT angiography (CTA) in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2015 to December 2018 were selected. According to Agatson score, the patients were divided into two groups, which were CAC scores≤100（n=72）and CAC scores>100 （n=125）. The relevant clinical indexes of patients were collected, and the serum apelin-12 level was detected by enzyme-linked immunosorbent assay to explore its relationship with CAC and its related cardiovascular events. Results The baseline characteristics in two groups showed that serum apelin-12 level in CAC scores >100 group was lower than that in CAC scores ≤100 group [79.50 （68.35，97.49） ng/L vs 91.94 （80.13，110.19） ng/L]， which showed significant difference（P=0.02）. Binary Logistic regression analysis showed that apelin-12 levels were associated with the occurrence of CAC in the unadjusted model （P=0.013）. After adjusting for the indicators with baselines difference， apelin-12 levels were still associated with the occurrence of CAC. Kaplan-Meier survival analysis found that compared to higher apelin-12 levels, lower apelin-12 levels were associated with an increased risk of cardiovascular events（Log rank test， P=0.019）. In subgroups with CAC scores >100， apelin-12 levels were associated with an increased risk of outcome events （Log rank test， P=0.035）. Cox regression analysis was used to determine the predictive effect of apelin-12 levels in different subgroups and found that the predictive effect of apelin-12 levels on outcome events was found to be stronger in patients aged > 65 years, with renal insufficiency and diabetes mellitus. Conclusions Serum apelin-12 is correlated with CAC and related cardiovascular events, suggesting that apelin-12 may be a biomarker for predicting CAC and its prognosis.