Background and Purpose : There is a strong correlation between CAD and ischemic stroke because both are caused by the same underlying process ; atherosclerosis.1 While the cerebral and myocardial vasculature are different, the occurrence of stroke and CHD is related to common risk factors .2 Relatively little is known about the prevalence and correlates of intracranial atherosclerosis in Egyptian patients with coronary artery disease. We investigate the presence and the extent of intracranial luminal stenosis in this population .Methods : On the basis of transcranial Doppler of the intracranial arteries with supplementary duplex ultrasound of the carotid arteries, we determined the number of occlusive arteries in the craniocervical circulation of 118 consecutive patients who were hospitalized for ischemic heart disease in cardiovascular department. : All subjects were evaluated for coronary atherosclerosis (number & severity of stenotic coronary arteries ) by conventional coronary angiography . Results : Among 118 consecutive Egyptian IHD patients studied, intracranial atherosclerotic stenotic disease were found in 6 patients (5%) , extracranial atherosclerotic stenotic disease were found in 47 patients (40 %), combined intra & extracranial atherosclerotic stenotic disease were found in 6 patients (511`11%).Conclusions : Egyptians IHD patients were found to have both intracranial as well asextracranial atherosclerotic involvements of 6.8 % and 40 %, respectively . Patients had old or present history of cerebrovascular event were found to have significantly more : three coronary vessel disease , thickened intima media complex, extracranial carotid (CCA & ICA) stenotic plaques & intracranial stenosis .