Atherosclerotic calcified nodule is rare but important cause of coronary artery thrombosis and acute coronary syndrome. Eruptive calcified nodule is characterized by clusters of burst like calcified fragments protruding into the lumen accompanied by ruptured fibrous caps and thrombus attached to the surface, which is a potential cause of sudden cardiac death. The prognosis of acute coronary syndrome caused by calcified nodule is poor, and the incidence of perioperative myocardial infarction, cardiac death, and target lesion revascularization is high. This article reviews the progress in the diagnosis and treatment of atherosclerotic calcified nodule in coronary artery.