Background: Although the association of renal artery stenosis (RAS) with coronary artery disease (CAD) is established, the best cutoff of diseased coronary vessels predicting atherosclerotic RAS remains still undefined. This study was designed to investigate the association between severity and locations of coronary artery stenotic lesions and atherosclerotic RAS. Methods: This study was composed of 365 consecutive patients who underwent simultaneous renal angiography following coronary angiography. Significant RAS was defined as ���50% luminal diameter stenosis. Significant coronary artery stenosis was defined as ���70% luminal diameter stenosis on coronary angiogram and multi-vessel coronary artery disease (CAD) was defined as ��� 2 vessels. Results: Overall prevalence of RAS was 14.8% (54 patients) and significant RAS was present in 21 patients (5.7%). 7 patients (1.9%) had right RAS, 12 patients (3.3%) had left RAS and 2 patients (0.5%) had both RAS. Significant CAD was present in 106 patients (29.0%). In cases with CAD, RAS was present in 11 cases (10.3%), in normal CAD, RAS was present in 10 cases (3.8%) and so significantly higher prevalence in patients with CAD (p=0.015). In multi-vessel CAD, RAS had significantly high prevalence. Also older age and higher intra-arterial systolic blood pressure at the time of catheterization were associated with significant RAS. However, the severity and locations of coronary artery stenotic lesions were not associated with significant RAS. If the patient was age more than 60 years, hypertension and multi-vessel CAD, sensitivity was 70%, specificity 100%, positive predict value 100%, negative predict value 85.4% and independent predictor of significant RAS. Conclusion: This study showed that the severity and locations of coronary artery stenotic lesions were not associated with significant RAS. However, simultaneous renal angiography following coronary angiography may be recommended in patients with multi-vessel CAD who are older than 60 years with hypertension.