Background: In Egypt there is lack of data concerning the prevalence of renal artery stenosis (RAS) in hypertensive patients who also suffer from coronary artery disease (CAD). Methods: We performed coronary and renal angiography to 85 patients. They were divided into two groups; a group of 65 patients suffering from hypertension and CAD, and a control group of 20 normotensive patients with CAD. After angiography, lesions of RAS were classified as hemodynamically significant (>60%) and non-significant (0-59%). To assess the value of duplex ultrasound in comparison to angiography for its ability to detect RAS, we performed the test on 40 patients from the first group. Results: In the first group of 65 patients, significant ostial stenosis was found in 10 patients (15.3%), insignificant ostial stenosis in 3 patients (4.6%), and branch stenosis in 2 patients (3%). Overall prevalence of RAS was 23%. The mean duration of hypertension for those patients was 8.7 years, 10.7% had peripheral vascular disease, 85% of whom had RAS (p=0.001). Renal angioplasty (PTRA) and stenting to seven patients (70%) of the 10 with significant ostial stenosis was performed, four patients (57%) had impressive fall in their respective systolic and diastolic blood pressures for up to 6 moths after PTRA and, three patients (43%) had improvement in their renal function. Three patients (43%) had no clinical or laboratory improvement despite technically successful PTRA. In the control group one patient (5%) had insignificant RAS. Duplex scanning had a sensitivity of 81% and specificity of 100% for detecting hemodynamically significant lesions.Conclusion: The prevalence of RAS in Egyptian hypertensive population with CAD referred for cardiac catheterization is 23%, which is fairly high. PTRA and stenting for patients with significant RAS proved a technical and clinical success, a much encouraging way of revascularization. Duplex scanning of the renal arteries is an accurate and convenient procedure with a high sensitivity and specificity for significant lesions and can be used for early screening of cases.