Background: This study aimed to investigate the impact of atorvastatin (Ato) combined with ezetimibe (Eze) for the treatment of carotid atherosclerosis in patients with coronary heart disease (CHD). Methods: One hundred and forty-eight CHD patients with carotid atherosclerosis were divided into the control (Ato alone) and combination (Ato and Eze) groups. The treatment course was 12 months; patient blood lipids, carotid intima-media thickness (CIMT), and carotid plaque area were measured before and after treatment. Results: Twelve months after treatment, there was a decrease in the CIMT, and the horizontal and vertical axes of the carotid plaque areas in both groups, compared to pretreatment values. The serum low-density lipoprotein cholesterol (LDL-C) levels were significantly decreased (p < 0.05). There were statistically significant differences (p < 0.05) in the LDL-C (2.12  0.58 mmol/L vs. 2.63  0.56 mmol/L) and CIMT (1.06  0.12 mm vs. 1.13  0.11 mm) levels between the combination and the control groups after treatment. Compared to the control group, the horizontal (0.18  0.06 cm2 vs. 0.19  0.05 cm2) and vertical carotid arterial plaque areas (0.40  0.15 cm2 vs. 0.41  0.17 cm2) of the combination group were reduced after treatment. However, the difference was not statistically significant (p > 0.05). Conclusions: The combination of Ato and Eze further reduces LDL-C levels and CIMT, and affect the progression of carotid atherosclerosis in CHD patients with hypercholesterolemia.