This review is devoted to the problem of detection of multifocal atherosclerosis (MFA) in patients with acute and chronic forms of ischemic heart disease (IHD). According to different sources rate of detection of MFA varies between 13.5 and 94%. According to register study conducted in the Kemerovo cardiological center it has been proved that isolated involvement of coronary vascular bed is an exemption and that some degree of MFA is found in most patients with ST-elevation myocardial infarction. It is considered that estimating thickness of carotid artery intima-media complex, degree of stenosis of extracoronary arteries one can not only predict severity of coronary atherosclerosis but also assess total risk of development of vascular catastrophes. According to results of our studies it has been shown that in patients with ST-elevation myocardial infarction and even hemodynamically insignificant stenoses in extracoronary vascular beds 12 month prognosis is substantially worse than in patients with MI without signs of MFA. In this connection it is necessary to include into routine practice of physicians observing patients with pathology of any vascular bed active detection and monitoring of involvement of other vascular beds in order to make timely decision on the use of effective methods of treatment and prevention of ischemic events.