Background: The transradial artery (TRA) approach is routinely used for coronary angiography. There are several reports about transradial carotid angiography, but, they required specialized devices with more cost and procedure time. This study investigated whether the TRA approach using conventional coronary diagnostic catheters for both carotid angiographies is safe and effective for patients with suspected carotid disease. Methods: From March 2006 to July 2007, a total of 1764 consecutive patients underwent diagnostic coronary angiography and 93.0% (n=1641) of procedures were performed using transradial approach. Among them, who has a history of stroke, transient ischemic attack, or carotid bruit on routine auscultation underwent both carotid angiography. We used conventional Judkins right (JR) catheter for right carotid angiography and Judkins left (JL) catheter for left carotid angiography. If the angiogram was unsatisfactory, additional catheters were used for successful angiogram. Results: A total of 116 patients were enrolled in this study. 62 patients (53.4%) were man and mean age was 67짹14. The overall procedural success (defined as completely evaluating both carotid arteries using only JL and JR catheters) rate was 90.5% (n=105). Simon II or Pigtail catheter was used for another 11 patients and final angiographic failure was occurred in 3 patients (2.6%). Significant carotid stenosis (> 50%), was found in 38.8% (n=45) and 6.9% (n=8) underwent staged percutaneous carotid intervention. No major adverse event was occurred after the diagnostic angiography including death, myocardial infarction, cerebrovascular accident or major bleeding requiring blood transfusion. Conclusion: TRA approach for carotid angiography using conventional JR and JL catheter seems to be safe and feasible in patients with suspected carotid disease during routine TRA coronary angiography.