Background: Coronary computed tomography angiography (cCTA) technology as a kind of non-traumatic examination has been widely used in clinical practice. There are major issues that need to be considered. One is how to obtain high quality images and at the same time effectively reduce the radiation dose. The second is coronary artery calcified plaque artifacts that seriously affect the depiction of plaque morphology and luminal stenosis. In case of dose reduction, these artifacts are more outstanding. Objectives: This study determined the value of sinogram-affirmed iterative reconstruction (SAFIRE) technology to assess coronarycalcified plaques. This value was compared with filtered back-projection (FBP) reconstruction. Patients and Methods: Sixty-three cases with calcified plaques diagnosed via coronary CT examination were selected. The mean CT-number, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), number of calcium plaques, edges, lumen situation, and the subjective image quality ratings of the cases using FBP and SAFIRE1-SAFIRE5 (six groups) were analyzed and compared. Results: The subjective ratings of image quality using SAFIRE1-SAFIRE5 reconstructions were significantly higher than those using FBP, with SAFIRE3 achieving the highest rating. Compared with FBP reconstruction, the differences in noise, SNR, and CNR using SAFIRE1-SAFIRE5 were statistically significant (P < 0.05), with SAFIRE5 reconstruction achieving the highest SNR and CNR, and FBP reconstruction achieving the lowest. The revealed numbers of calcium plaques in the SAFIRE1-SAFIRE5 reconstruction groups were higher than that in the FBP reconstruction without significant differences in the number of calcium plaques among the SAFIRE1-SAFIRE5 groups (P > 0.05). Conclusion: SAFIRE reconstruction provided better coronary image quality and displayed the number, morphology, and surrounding lumen of calcium plaques more accurately than traditional FBP reconstruction, with SAFIRE3 achieving the best results.