Background: Thickened carotid intima-media or a carotid plaque represents carotid atherosclerosis. Intracardiac calcification (ICC) is a marker of atherosclerosis. It is unknown which of these localized atherosclerosis is better to predict generalized atherosclerosis. Subjects & Methods: This study included 282 patients (mean age 58.2짹10.7 years; women 45.4%) who underwent diagnostic coronary arteriography (CAG). Patients underwent carotid ultrasonography, transthoracic echocardiography, and measurements of brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABI) before CAG. Positive results of significant atherosclerosis were defined as follows: coronary artery stenosis ���50% (coronary artery disease, CAD); carotid intima-media thickness >0.75 mm or a carotid plaque (carotid atherosclerosis, CA); aortic valve calcification (AVC) or mitral annulus calcification (MAC); baPWV >1450 cm/s (high baPWV); ABI <0.90 (peripheral arterial disease, PAD). Results: CA was associated with CAD (56.5 vs 29.5%, p<0.001), AVC (57.1 vs 34.3%, p<0.001), high baPWV (69.1 vs 43.7%, p<0.001), and PAD (4.9 vs 0.0%, p=0.025), but not with MAC (51.4 vs 43.8%, p=NS). AVC was associated with CA (73.7 vs 52.4%, p<0.001), and high baPWV (70.1 vs 49.3%, p=0.001), but not with CAD (49.6 vs 43.4%, p=NS) and PAD (3.1 vs 2.9%, p=NS). There was no relationship between severity of AVC and CAD (p=NS). MAC was not associated with CAD, CA, high baPWV, and PAD. Among 3 findings of atherosclerosis (CAD, high baPWV, and PAD) other than CA and AVC, CA discriminated 2 or more atherosclerotic findings [AUC 0.66 (95% CI, 0.59-0.73; p<0.001)], whereas AVC did not [AUC 0.57 (95% CI, 0.50-0.64; p=0.061)]. Conclusion: These findings suggest that CA is better than ICC in predicting generalized atherosclerosis.