In this retrospective cohort study of 165 patients with a low CAD risk, two important findings were obtained: (1) in addition to traditional risks, such as age, male gender, DM, and hypertension, elevated fatty liver scores, including NFS, Fib-4, and Forns scores, were observed in subjects with mild atherosclerosis and in the initial stages of CAD; and (2) the male gender, DBP, and NFS are independent factors associated with atherosclerotic plaque progression in these low-coronary-calcium-score subjects. Here, FBL is linked to atherosclerosis.