A pre-clinical sign of atherosclerisis is hypertrophy of arterial wall. Femoral intima-media thickness is noninvasive marker of arterial wall alteration, which can easily be assessed by high resolusion B mode ultrasound. Aims: To investigate the correlation between femoral intima-media thickness and the severity of coronary artery diseases. Methods: 111 consecutive patients with coronary artery diseases were enrolled. Femoral intima-media thickness was assessed by B mode ultrasound with 7.5 - 10 MHz probe about 10 - 15 mm before bifurcation to profond and superfacial femoral arteries. The femoral intima-media thickness < 1.0 mm is named as “normal”, ≥ 1.0 mm is “thick” and ≥ 1.5 mm is defined as “atherosclerosic femoral plaque”. The severity of coronary artery diseases was calculated by Gensini Score. Results: Mean femoral intima-media thickness was 1.57 ± 1.23 mm, 55% patients with abnormal femoral intima-media thickness (male 57.0%  vs female 50.0%), 36.9% of patients with coronary artery diseases had atherosclerosic femoral plaque. There was a good correlation between femoral intima-media thickness and severity of coronary artery diseases by Gensini score and its risk factors (age, plasma glucose, smoking, hypertension…). Conclusion: Patients with coronary artery diseases are likely to have concomittant peripheral artery disease with high frequency of femoral artery wall changes. Femoral intima-media thickness could be a helpful diagnostic marker and therapeutic points.