Breast artery calcification (BAC) is increasingly recognized as a specific marker of medial calcification and may help to identify risk factors of medial artery calcification. Amongst these are high age, diabetes mellitus, hypertension and chronic kidney disease (CKD). Present retrospective observational cohort study focused on the latter patient group with CKD and aimed to define the prevalence and progression rate of BAC in chronic kidney disease (CKD) patients across stages of disease, to define clinical and biochemical correlates of BAC and to explore the association of BAC with incident cardiovascular morbidity and mortality. The main findings of the present observational study are as follows: (a) BAC is common in CKD and its prevalence, severity and rate of progression increase parallel to the degree of kidney dysfunction; (b) inflammation and hyperphosphatemia are (nontraditional) risk factors for BAC in CKD patients; and (c) BAC associates with a dismal cardiovascular outcome in renal transplant recipients. In conclusion, BAC is common among CKD patients, progresses at a slower pace in Tx patients as compared to CKD5D patients, and associates with dismal cardiovascular outcomes. BAC score, kidney function and serum phosphate at baseline seem to be important determinants of progression. BAC is not routinely mentioned in mammogram reports, while the measurement of BAC may offer a personalized, non-invasive approach to risk-stratify CKD patients for cardiovascular disease at no additional cost or radiation since a majority of women over the age of 40 undergo regular breast cancer screening.