BACKGROUND Coronary artery disease (CAD) is one of the leading causes of death and disease burden in China and worldwide. A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgently needed for primary prevention. OBJECTIVE To examine whether the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) scoring system could be used for this purpose. METHODS A total of 6813 consecutive patients who underwent diagnostic coronary angiography were enrolled. The China-PAR score was calculated for each patient and CAD severity was assessed by the Gensini score (GS). RESULTS Correlation analysis demonstrated a significant relationship between China-PAR and GS (r = 0.266, P < 0.001). In receiver operating characteristic curve analysis, the cut-off values of China-PAR for predicting the presence and the severity of CAD were 7.55% with a sensitivity of 55.8% and specificity of 71.8% [area under the curve (AUC) = 0.693, 95% confidence interval: 0.681 to 0.706, P < 0.001], and 7.45% with a sensitivity of 58.8% and specificity of 67.2% (AUC = 0.680, 95% confidence interval: 0.665 to 0.694, P < 0.001), respectively. CONCLUSIONS The China-PAR scoring system may be useful in predicting the presence and severity of CAD.