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Objectives: Coronary tortuosity (CT) is a common coronary angiography result and the clinical significance of CT is not clearly understood. In this study, the relationship between the presence of CT with CHA2DS2-VASc score and atrial fibrillation (AF) was analyzed. Materials and Methods: Our study included 511 patients who underwent coronary angiography with evidence of coronary artery ischemia. All patients were assessed for the presence and severity of CT. Three or more bends that caused at least 45° changes in the main body of the coronary artery in both systole and diastole were defined as CT. The study patients were divided into groups according to the presence and severity of CT. Results: CHA2DS2-VASc score was higher in the significant (SCT) group (p=0.001). Increased CHA2DS2-VASc score, regardless of age and female gender, was statistically SCT only for the presence of LAD SCT [p=0.003, adjusted odds ratio (OR): 1.95, 95% confidence interval (CI): 1.69-2.20]. Left anterior descending (LAD) SCT (p=0.014, OR: 3.11, 95% CI: 1.25-7.69) was reported to be a possible predictor of AF. Conclusion: Patients who have LAD SCT observed on coronary angiography should be considered for periodic verification with electrocardiography in terms of AF development. [ABSTRACT FROM AUTHOR]