Abstract: The purpose of this study was to investigate role of predictive value of carotid artery ultrasonography on the basis of intima-media thickness in coronary artery disease. Ultrasonography and quantitative coronary angiography were achieved for assessment carotid and coronary artery diseases in 80 consecutive patients (mean age 57.37 years) with chest pain that referred for cardiac catheterization. Mean values of parameters were recognized that carotid artery atherosclerosis to be equally involved between left and right carotid arteries. Fifty nine (73.8%) of patients had coronary artery atherosclerosis. Degree of involvement in coronary arteries regarding the O-vessel, 1-vessel, 2-vessel, 3- vessel and LMS-CAD were 26, 30, 21, 15 and 8%. The most of patients have 1-VD involvement. There is a significant association between mean IMT of carotid and CAD. The 80% of patients had increased IMT (≥0.8 mm). None of patients with normal coronary angiography have IMT most of 1.2 mm. Carotid disease has a acceptable sensitivity (87%), Specifity (43%), negative predictive value (54%) and positive predictive value (81%) for presence of CAD. In patients that assessment for chest pain, increased IMT of carotid artery in ultrasonography (≥1.2 mm) has significantly related to presence of CAD. Patients with mean IMT over 1.2 mm, 87% likehood of presence of coronary artery stenosis in our region that must be evaluated, treatment and followed. Therefor, measurement of carotid IMT seem to be a predictive parameter for presence and severity of CAD. This is a useful, noninvasive peripheral marker for assessment presence of coronary artery disease.