Introduction: In recent decades, a high incidence of cardiovascular disease in the overall structure of mortality has been registered, with the prevalence of obesity, as one of the most important risk factors for the development of cardiovascular disease, which is reaching epidemic proportions worldwide. In terms of the risk of developing cardiometabolic complications of obesity, there is a significant increase in visceral fat tissue depots, which causes an increased risk in postmenopausal women. Epicardial adipose tissue (EAT) stands out as a very important visceral fat tissue depot, which is anatomically and functionally in close contact with the myocardium and coronary arteries and has a cardioprotective role, but its dysfunction in obesity leads to atherosclerotic changes in these blood vessels and causes the development of coronary disease. This study aimed to analyze the mass and distribution of total adipose tissue, volume, and distribution of EAT in correlation with nutritional status (BMI), menstrual status, and risk of developing the coronary disease in women. Material and methods: The study included 221 women of varying degrees of nutrition, menstrual status, and risk of coronary heart disease, who underwent anthropometric measurements and imaging of coronary blood vessels by computed tomography (CT coronary angiography). Results: Subjects with coronary artery stenosis had higher BMI, higher values of central obesity, higher values of calcium score, and higher values of EMT volume compared to subjects with normal coronary artery findings, and left anterior descending artery (LAD) was the most affected by changes. The predictive value of EAT volume was 70.97 ml and it was defined in relation to the degree of coronary artery stenosis. Obese postmenopausal subjects had a significantly higher volume of EAT (99.87 Β± 37.77 ml), both compared to normal weight postmenopausal (67.19 Β± 30.78 ml) and premenopausal subjects with different degrees of nutrition (normal weight: 48.44 Β± 29.38 ml; obese: 60.00 Β± 23.35 ml). Age was positively correlated with EAT volume, especially due to the increase in EAT thickness in the region of the anterior interventricular groove, the right edge of the heart, the anterior free wall of the right ventricle as well as the upper right ventricular wall. Pre- and postmenopausal subjects with central obesity had a significantly higher EAT volume compared to those with normal waist circumference values. Age, waist circumference, time spent in sedentary activities, and EAT thickness at the level of the upper right ventricular wall (65% of variance) proved to be the best predictors of EAT volume.Β Conclusion: EAT volume in women increases significantly during aging, especially after menopause. EAT volume correlates with central obesity regardless of menopausal status and level of nutrition, as well as with the degree of coronary artery stenosis, which is conditioned by age.