© 2016 by Wroclaw Medical University and Polish Dental Society. Background. Early detection of carotid artery calcification on panoramic radiographs may play an important role in the prevention of cardiovascular disease. Objectives. This study assessed the prevalence of carotid artery calcification (CAC) on digital panoramic radiographs (PRs) of Iranian population, as well as associations with medical history, age and gender. Material and Methods. A total of 4,847 patients that attended dental radiology clinics were included in this study. After filling out the questionnaires, which included demographic information, history of cigarette smoking, and history of systemic disease related to CAC (hypertension, hyperlipidemia, diabetes mellitus, cardiovascular diseases, renal diseases), dental panoramic view radiographs were taken. The presence of CAC on all radiographs was determined by a maxillofacial radiologist and a senior dental student (trained by a maxillofacial radiologist) on the intervertebral space of C3–C4. Chi-square tests and Kruskal-Wallis tests was used to detect any significant statistical differences. Results. CAC was observed on 373 PRs (7.7%). There was a significant difference in prevalence of CAC on PRs between patients without and with systemic disease, and smoking (p <0.05). Conclusions. Dentists need to refer patients for an evaluation, if nodular and linear opacity on the intervertebral space of C3–C4 on PRs were observed, especially in patients with a history of systemic disease.