To study the prevalence of ASYMPTOMATIC CAROTID ARTERY DISEASE and to identify predictive factors of carotid artery disease, in patients with critical limb ischemia in south Indian patients Materials and methods:-Total of 250 patients with critical limb ischemia admitted in department of vascular surgery, madras medical college, Chennai, underwent carotid duplex scanning by department of radiology, madras medical college, Chennai and a questionnaire was used to collect data concerning known risk factors. Results:-The mean age of the patients was 50±20 years; there were 242 (96.8%) men and 8 (3.2%) women; 72% of the patients had a history of smoking, 10.4% had coronary artery disease, 5.6% had hypertension, 5.6 % had dyslipidemia and 17.2% had diabetes mellitus. Eighteen (7%) patients had carotid artery disease detected by carotid artery duplex scanning of which insignificant Carotid artery disease found in 10 patients, significant carotid artery stenosis in 5 patients and complete occlusion of ICA in 3 patients. Conclusion:-All patients with peripheral vascular disease with large vessel occlusion due to atherosclerosis have to be screened for carotid artery disease.