Introduction: Mitral annular calcification is an asymptomatic degenerative process found incidentaly in echocardiografic examination for other reasons.The aim of the study is to analyse clinical and echocardiographic characteristics of patients with mitral annular calcification (MAC). Methods: A series of 200 consecutive patients with in dications for echocardiographic examination, older than 55 years, were analysed. 44 patients presented MAC and were compared with 44 patients with the same age distribution, without MAC . Results: Average age in group with MAC was 74 ± 4 years old, significantly higher than the averrage age of the series 63 ± 6 years old. Compared with the group with the same age distribution without MAC, we found a higher incidence of ischaemic heart disease (65% vs 49%), stroke or TIA (18% vs 5%), carotid vascular disease (67% vs 43%), peripheric artelial disease (22% vs 12%), atrial fi brillation (27% vs 19%), diabetes mellitus (21% vs 11%) and renal failure (13% vs 4). 32% of patients with MAC had also aortic calcifications. MAC was asociated with mild or moderate regurgitation in 88% of patients and mitral valve openning restrictiction in 5% of patients. Conclusions: Mitral annular calcifi cation reflects a long evolution of atherosclerosis and is strongly associated with advanced age and metabolic disorders like renal failure and diabetes mellitus. MAC has no severe functional consequences, but represents an echocardiographic marker of systemic atherosclerosis.