Coronary artery disease (CAD) is an important determinant of long-term outcome in patients with lower extremity artery disease (LEAD). In this study we evaluated the CAD prevalence among LEAD patients and the association of LEAD lesions location with the CAD presence and severity. 203 patients with LEAD, referred for peripheral and simultaneous coronary angiography, were evaluated. LEAD and CAD were considered angiographically significant for stenosis higher than 50% of arterial lumen. More than two-thirds of LEAD patients had significant CAD, half of them having multi-vessel CAD and a quarter single CAD. Infrapoplitheal arterial lesions seemed to be the strongest predictor of CAD being associated with significant and multi-vessel CAD and also with the presence of left main (LM) lesions. Femoral artery lesions were highly associated with multi-vessel CAD, but there was no association with significant CAD and LM lesions. No association was found between iliac artery lesions and CAD.