Aim To explore the essentiality of renal angiography while undergoing routine coronary angiography and evaluate the correlated risk factor of atherosclerotic renal artery stenosis (ARAS). Methods Abdominal aortography or slective renal angiography was performed immediately after routine coronary angiography in 491 patients with suspected coronary artery disease. Univariate analysis and multivariate Logistic regression analysis were made to evaluate the association of the clinical variables with renal stenosis. Results Incidence of renal artery stenosis was 20% (44/220) in patients with coronary artery disease who were identified by coronary angiography. Only 7 cases with renal artery stenosis were found in 271 cases whose coronary arteries were normal (2.6%). Multivariable predictors of ARAS included coronary artery disease (p<0.001) and peripheral vascular disease (P=0.003). Conclusions Renal angiography should be routinely performed in patients with suspected coronary artery disease while undergoing routine coronary angiography to identify ARAS, especially in patients associated with peripheral vascular disease.