Background : Few data exist correlating cardiovascular risk factors with radial artery atheroma burden in patients performing transradial coronary angiography/intervention. Objectives : The goal of this study was to determine the relationship between established cardiovascular risk factors and the extent of radial artery atherosclerotic plaque. Methods : Clinical characteristics, quantitative coronary angiography, and intravascular ultrasound(IVUS) were evaluated in patients performing transradial coronary angiography/intervention. Total 50mm segments from radioulnar bifurcation were analyzed at 2-mm intervals to compute atheroma volume. Data on cardiovasular risk factors were collected. Results : In 115 consecutive patients, atheroma volume averaged 134.8 mm쨀and percent atheroma volume 25.2%. In univariate analysis, there was a strong association between age, male gender, height, history of hyperlipidemia with total atheroma volume. Age, diabetes, hypertension, systolic blood pressure were predictive of larger percent atheroma volume. Low-density lipoprotein and high sensitive C-reactive protein were not significant predictors of greater disease burden. In multivariate analysis, Age and hypertension were strong independent predictors of both total atheroma volume and percent atheroma volume. Male gender was an independent predictor of total atheroma volume, whereas diabetes mellitus was an independent predictor of percent atheroma volume. Patients with significant coronary artery disease(CAD) had larger percent atheroma volume in radial artery than patients without significant CAD. Conclusion : Radial artery atherosclerosis can be quantitatively analyzed by IVUS and could be used as a surrogate marker for atherosclerosis.