Background and Objectives : There are common anatomical variations of the coronary arteries. The coronary arteries are equally exposed to systemic risk factors but coronary angiography shows focal and uneven distribution of atherosclerosis. We investigated the influence of coronary dominance on coronary atherosclerosis and distribution of coronary artery disease. Subjects and Methods : A total 264 patients (170 men, 94 women) with typical or atypical chest pain were enrolled for analysis. By using ACC/AHA anatomic angiographic definition, coronary dominance was assessed visually as right dominant artery, left dominant, and balanced dominant. The stenosis of coronary artery was obtained angiographically by scoring system. Using the sum of numerical values in three vessels, total left anterior descending artery (LAD) score, total left circumflex artery (LCX) score, and total right coronary artery (RCA) score were calculated. Results : Of the 264 patients, right dominance was 73.5% (194/264), left dominance was 16.3% (43/264) and balabced dominance was 9.8% (27/264). Total LAD score (3.44짹1.84 vs 4.00짹1.98 vs 3.74짹1.79), total LCX score (3.10짹2.50 vs 3.19짹2.46 vs 2.96짹1.95), total RCA score (3.95짹2.18 vs 3.81짹2.85 vs 3.41짹2.50) were similar in patients of three dominance groups (P>0.05). These coronary atherosclerotic lesions were not uniformly distributed throughout coronary arteries. The coronary artery disease score also demonstrated higher coronary artery disease score in the proximal and mid artery (LAD, P=0.000; LCX, P=0.002; RCA, P=0.041). Conclusion : The coronary dominance was not related to the angiographic severity of coronary artery disease. The distribution of coronary disease in three coronary arteries tended to cluster within the proximal and mid segment of the vessel.