To evaluate the relationship between intramammary arterial calcifications detected by screening mammography and concomitant coronary artery disease, detected by coronary angiography. We retrospectively evaluated screening mammography and coronary angiography results of 131 consecutive patients, ages 42-81 years. Risk factors for coronary artery disease (hypertension, diabetes mellitus, dyslipidemia, smoking, and obesity) were obtained from medical records to identify possible simultaneous risk factors for coronary artery disease. Eighty-five women had coronary artery disease (41 with intramammary arterial calcifications and 44 without such calcifications) and 46 had normal coronary angiography (11 had intramammary arterial calcifications and 35 did not). A strong association between intramammary arterial calcifications and coronary artery disease was seen, with an OR of 2.96 and P = .006 in the raw model and OR of 4.6 in the adjusted one. The evaluated risk factors did not present as confounding variables. Most patients had only two risk factors or less. The most prevalent risk factor for coronary artery disease was hypertension, with significantly higher prevalence in the coronary artery disease group (P < .01). A strong association exists between intramammary arterial calcifications and coronary artery disease. Therefore a mammographic finding of intramammary arterial calcification should receive more of the radiologists' attention and its presence should never be omitted from the final report.