The aim of this study was to explore the relation between atherosclerosis of the retinal arteries and the extent and severity of coronary artery disease (CAD). In 109 patients, aged 40 to 80 years, who underwent coronary angiography for suspected CAD, the degree of retinal arterial atherosclerosis (stages 1 to 4 according to Scheie) was determined. The fundus examination was done using direct ophthalmoscopy by an ophthalmologist blinded to the extent of the CAD. The CAD extent was evaluated by Gensini score, and coronary angiograms were analyzed by 2 expert observers who had no knowledge of the patients’ retinal artery status. The extent and severity of retinal vessel atherosclerosis correlated strongly with the extent and severity of CAD. Thus, atherosclerotic changes in the retinal arteries may be a predictor of the extent of CAD.