Aim To compare and analyze carotid atherosclerosis and coronary artery lesion between Xibo and Han patients with coronary heart disease. Methods Carotid ultrasound was performed in 48 Xibo,57 Han nationality patients and 50 normal controls who had been diagnosed by coronary angiography,then the intima-media thickness (IMT),the prevalence rate of atherosclerotic and Gensini score of coronary artery lesion were compared. Results IMT and prevalence rate of atherosclerotic of Xibo and Han nationality patients were higher than the normal control group (1.1±0.3 mm and 1.0±0.1 mm vs 0.6±0.2 mm,88.3% and 77.2% vs 38.0%,P><0.05),but there was no significant difference between Xibo and Han nationality patients (P>0.05); The number of coronary artery lesion of Xibo nationality patients was less than Han nationality patients (1.82±0.24 vs 2.54±0.31,P><0.05); The Gensini score of coronary artery lesion of Xibo nationality patients was obviously less than Han nationality patients (8.23±1.35 vs 15.84±2.68,P><0.05). Furthermore,the more serious coronary artery lesion,the higher incidence rate of carotid atherosclerosis. Conclusions The carotid atherosclerosis of Xibo and Han nationality patients was serious than the normal control group,but there were no significant differences between Xibo and Han nationality patients; There were differences between Xibo and Han nationality patients about coronary artery lesion,and the coronary artery lesion of Han nationality patients was more serious than Xibo; The extent of IMT can reflect the occurrence and serious extent of coronary artery lesion.