Relatively little information is available on the status of the coronary arteries in patients with Buerger's disease (thromboangiitis obliterans). No detailed analyses of the coronary arteries have been reported at necropsy in patients with Buerger's disease. We described a 32-year-old man with this disease and he had severe coronary narrowing due to atherosclerosis, not to thromboangiitis obliterans.