Objective To explore the association between the non-alcoholic fatty liver disease (NAFLD)and coronary atherosclerosis. Methods A case control study performed, patients suspected coronary atherosclerotic heart disease in-cluded, coronary angiography done to diagnosis the coronary atherosclerosis, and assess the severity of coronary atherosclerosis. NAFLD were diagnosed in 59 patients, 41 cases of non-NAFLD patients defined as control group. The weight, height and other body information, transaminase, cholesterol, blood sugar and other biochemical markers were assessed. Results The prevalence of NAFLD was higher in the patients with coronary atherosclerosis than the control group. Meanwhile, the coronary atherosclerosis severity score (Gensini score) were higher in NAFLD patients than the control group. Conclusion There is significant association between NAFLD and coronary atherosclerosis.