Coronary artery fistula(CAF) is an uncommon congenital cardiac malformation, which may lead to coronary steal manifesting as angina. But, the magagement of coronary arteriovenous fistula is controversial, especially regarding operative intervention in asymptomatic patients. We experienced two patients with coronary atherosclerosis with coronary artery fisula. Case 1. A 44-year-old-man developed an exertional chest pain. Coronary angiography revealed CAF arising from both RCA and LAD, draining into the pulmonary artery, and critical stenosis of distal RCA. Stent was deployed, which obtained a good angiographic results. The patient remained asymptomatic and performed an exercise stress test and angiography at 6 months, which was negative. Case 2. A 58-year-old man with a history of hypertension presented with stable angina. Coronary angioraphy documented CAF from LAD and critical stenosis at mid-LCX. Stent was deployed and minimal neointimal hyperplasia of stent edge at 6 month follow-up angiography. Standard treatment of CAF is surgical ligation and may be transcatheter coil occlusion, which has still mortality and morbidity. In this case, after combing coronary atherosclerosis was treated by stenting, two patients had no chest pain, which was not due to CAF. In CAF with coronary atherosclerosis, chest pain may be due to conary atherosclerosis, which will be treated at first.