To determine whether carotid intima-media thickness is associated with coronary artery disease and cardiovascular risk factors in the Indian population, carotid intima-media thickness was measured using high-resolution B-mode ultrasonography in 101 patients with coronary artery disease and 140 control subjects. Carotid intima-media thickness was measured at 3 predefined sites on each side. The maximum carotid intima-media thickness was significantly higher in the coronary disease group compared to the controls (1.02 vs. 0.80 mm). The average intima-media thickness was also significantly higher in the coronary disease group (0.82 vs. 0.67 mm). On multivariate logistic regression analysis, carotid intima-media thickness was the only factor found to be an independent predictor of coronary artery disease. There was a significant association between risk factor count and the average and maximum intima-media thickness values in the combined study population. These results indicate that raised values of average and maximum carotid intima-media thickness are significantly associated with the presence of coronary artery disease and this association is independent of the presence of other conventional cardiovascular risk factors.