OBJECTIVE To investigate the diagnostic value of peripheral artery ultrasonography for coronary atherosclerotic disease (CAD). METHODS Peripheral artery ultrasonography was conducted among 135 consecutive examinees of coronary arteriography before the CAG. The results of peripheral artery ultrasonography and of coronary arteriography were analyzed with Stepwise multiple regression analysis and Logistic regression. RESULTS The incidence of atherosclerotic plaques of carotid, subclavicular, abdominal aortic, iliac and femoral arteries in patients with positive coronary arteriography was significantly higher than that in the subjects with negative coronary arteriography (P < 0.01); Logistic regression indicated that the presence of atherosclerotic plaques in femoral, abdominal aortic, and common iliac arteries was significantly closely correlated with CAD (P < 0.005, < 0.01, and < 0.05 respectively). Stepwise multiple regression analysis showed that common iliac IMT and femoral IMT were significant closely associated with the severity of coronary atherosclerosis (P < 0.0001). For each increased 1mm of iliac and femoral IMT, the LOG (1 + Gensini's score) of coronary arteriography increased by 0.227 and 0.219 respectively. The carotid artery IMT was partly associated with the LOG (1 + Gensini's score) of coronary arteriography (P < 0.05). The total score of extracoronary atherosclerosis (TSEcAS) was significantly correlated with the occurrence and severity of CAD (P < 0.0001). For 1 more extracoronary atherosclerotic plaques, the odds ratio and LOG (1 + Gensini's scores) for CAD increased 4.98 times and 0.323 respectively. Common iliac atherosclerosis was closely correlated with the occurrence of acute myocardial infarction. The positive predictive value of femoral, iliac atherosclerosis is 87.9%, 86.7%, 80.0% respectively; the positive predictive value for 2 and 3 sites of 3 above sites and is 88.6% and 94.9% respectively. Accuracy of discriminative function for positive and negative results and total was 91.5%, 93.8% and 92.5% respectively. CONCLUSIONS EcAS is closely correlated with CAD. It is possible to predict the occurrence, development, extent and severity of coronary artery atherosclerosis by extracoronary atherosclerosis. Common iliac atherosclerosis and femoral atherosclerosis are two independent factors closely correlated with the occurrence and progression of coronary atherosclerosis and can be used as the alternative indicators in study of coronary atherosclerosis.