Background: Atherosclerosis is a diffuse vascular disease, which may have a common mechanism of stenosis in both carotid and coronary arteries. Cardiovascular and cerebrovascular events happened due to the atherosclerosis are the causes of more than 50% of deaths in developed countries. Determination of IMT of large superficial arteries, especially the carotid, using B-mode ultrasonography has emerged as one of the methods of choice for determining early structural deterioration of arterial wall and assessing cardiovascular risk. Methods: This is a multicenter prospective study conducted at Kobry El-Kobba and El-Maadi Military Hospitals from 3-2021 to 12-2021. Included 300 cases subjected to both MSCT and carotid duplex. Results: The mean age of symptomatic patients (n=116) enrolled during the study was 66.6±11.8, while was 56±9.5 for asymptomatic patients (n=184). Subjects referred for screening were younger with less CAD on CT, hypertension, and diabetes compared with subjects with symptoms or known CAD. In our study, we observed high prevalence of carotid plaque (71%) as compared with other studies. There was a significant association between carotid plaque and IMT and CACs score and coronary artery disease by MSCT. Conclusion: Carotid IMT and plaque are associated with the presence and degree of coronary calcification and disease on CTA.