We performed both peripheral and coronary angiographies in 52 patients with an arteriosclerosis in lower extremities. The severity of arteriosclerotic narrowing of the coronany and peripheral anteries were compared on angiographies. An angiographic vascular score(AVS, 0-5) reflecting the number and the degree of stenosis in 12 lower extremity arteries and three major coronary arteries was assigned to each angiogram and the sum of scores in the lower extremity arteries was compared with the incidence of significant coronary artery disease(more than grade 3) and coronary score. Relation of incidence and severity of vascular stenosis and four risk factors(diabetes mellitus, hypertension, smoking, and hypercholesterolemia) was also analyzed. Thirty-four of 52 patients(65%) had an angiographically significant coronary artery disease. Thirteen of these 34 patients (38%) had no clinical symptom and sign of the ischemic heart disease. There was no statistically significant difference in the incidence and severity of coronary artery disease between high (more than 30) and low AVS group in lower extremity(P>0.14). All patients had at least one risk factor and 49 of 52 patients(94%) had multiple risk factors. Coronary angiography was normal in three patients with only one risk factors, and angiographically significant coronary artery disease existed in nine of 16 cases(56.3%) with two risk factors. 13 of 17 cases(76.5%) with three risk factors, and 12 of 16 cases(75.0%) with all four risk factors. There were no significant correlations between individual risk factors and incidence, severity of arteriosclerosis in coronary and lower extremity arteries. In conclusion, angiographic evaluation of the coronary artery disease in patients with lower extremity arteriosclerosis is necessary because of the high chance of coronary artery disease and difficulty in the prediction of coronary artery disease with a severity of the peripheral arteriosclerosis, presence of various risk factors, and clinical symptoms.