<h4>Introduction</h4>We examined neurofibrillary tangle (NFT) pathology using 18F-RO-948 tau positron emission tomography (PET) in cognitively unimpaired individuals and its associations with amyloid plaques, fluid biomarkers, and cognition in early preclinical Alzheimer's disease (AD).<h4>Methods</h4>We analyzed 97 participants from the ALFA+ cohort with tau and amyloid PET, magnetic resonance imaging, fluid biomarkers (cerebrospinal fluid [CSF]/plasma), and cognitive data. This evidence concerns the gene MAPT and Neurofibrillary tangles.