The aim of this study was to determine the relationship between the presence of carotid artery calcification (CAC) and pulp stone (PS). A total of 60 chronic hemodialysis (HD) patients (30 CAC positive, 30 CAC negative) participated in this study. The mean age of patients was 54.7 +/- 16.4 years, and 32 (53%) of them were male. CAC was defined as the presence of heterogeneous nodular opacities in the soft tissue in C3-C4 intervertebral area. Panoramic radiographs of the patients were evaluated for CAC and PS by two oral and maxillofacial radiologists. PS was evaluated in all healthy, decayed, and restored teeth except the third molar teeth, in the coronal, sagittal, and axial planes. The Statistical Package for the Social Sciences (version 20.0; SPSS, Inc., an IBM Company, Chicago, IL, USA) was used. A probability P <0.05 was considered statistically significant. The prevalence of PS in this study was 30% (18 patients) all group. A total of 1324 teeth were analyzed and PS was detected in 237 teeth (17.9%). The occurrence of PS in teeth in CAC-positive group (10 patients, 17.2% of 654 teeth) was similar to that in CAC-negative group (8 patient, 18.3% of 670 teeth). There was no statistical correlation between CAC and PS in chronic HD patients (P = 0.08). In the subgroup analysis, the presence of diabetes (P = 0.003), parathormone level (P = 0.02), calcium x phosphorus product (P = 0.04), and C-reactive protein levels (P = 0.002) were higher, and duration of HD (P = 0.03) was significantly longer in patients with CAC-positive and PS. In chronic HD patients, the presence of PS was not a strong predictor for the presence of CAC.