Purpose: Atherosclerosis is known to be a cause of various cardiovascular disease and causes fatal coronary artery disease (CAD). The carotid initma-media thickness (IMT) and coronary calcium score (CCS) are noninvasive measures of atherosclerosis. In our study, we evaluated the association between IMT, CACS and presence, extent of CAD on multidetector computed tomography (MDCT). Methods: 491 patients who had measured CCS by MDCT were studied. The patients had no prior history of revascularization. The CCS, presence and extent of CAD on MDCT were evaluated. In carotid ultrasonography, common carotid artery mean IMT and plaque score (PS) by summing all plaque thicknesses were calculated. Results: Significantly higher values of CCS, IMT and PS were observed in patients with CAD ( CCS-416.02짹662.96 vs 1.82짹13.45, IMT-0.79짹0.18mm vs 0.66짹0.17mm, PS-2.62짹5.81 vs 1.01짹3.20, respectively, p<0.05). Extent of any plaques was positively correlated with CCS, IMT and PS (p=0.000, p=0.000, and p=0.001). Univariate analysis showed that age, CCS, IMT and PS were significantly correlated with obstructive CAD (age-odds ratio (OR) 1.06 and p=0.00, CCS-OR 1.11 and p=0.00, IMT-OR 278.1 and p-0.00, PS-OR 1.10 and p=0.03) On multivariate regression analysis after adjustment age, significant clinical predictor of obstructive CAD was CCS (OR 1.31, p=0.014). ROC curves showed CCS could predicted obstructive CAD (>50% luminal stenosis ) significantly using cut-off value 283.5 (sensitivity 81.8%, specificity 72.7%, p=0.001). Conclusions: Our data suggest that CCS and IMT is associated with presence and extent of CAD, and CCS is better than IMT to predict the obstructive CAD.