Calcification is a common feature of abdominal aortic aneurysm (AAA), but its role in the pathogenesis of the disease remains incompletely understood. While heavy arterial macrocalcification is thought be a marker of disease stability, earlier stages in osteogenic remodelling of AAAs marked by microcalcification represent active disease associated with a healing response to inflammation and carry a greater risk of aneurysm expansion. Whether tracking changes in calcification using 18F-sodium fluoride (NaF) positron emission tomography (PET) after therapeutic intervention can improve risk-stratification in AAA is the thought-provoking topic of the proof-of-concept study by Debono et al. published in Heart.