Background: Patients that undergo renal transplantation (RT) often suffer from high rates of cardiovascular disease-related mortality, yet, most of the studies focus on coronary angiography performed as screening to entry in a waiting list and not, as for clinical indication, after renal transplantation. Methods: This study examined coronary angiography findings from 45 patients with functional renal grafts for over 6 months that were analyzed in Anzhen Hospital (Beijing, China) from 2014–2019. For comparison purposes, we additionally examined coronary angiography findings from 45 age- and sex-matched patients undergoing chronic dialysis due to end-stage renal disease (ESRD). We used the SYNTAX score to gauge coronary artery disease (CAD) severity. Results: The duration of ESRD in patients in the RT group was significantly longer than for that of patients in the dialysis comparison group (19.31 \pm 7.83 years vs. 11.43 \pm 8.04 years, p 0.001). The SYNTAX scores for patients in the dialysis and RT groups were 17.76 \pm 7.35 and 12.57 \pm 5.61, respectively (p 0.01). We found that 64.4% and 28.9% of dialysis and RT patients, respectively, exhibited the presence of moderate or severe calcified lesions upon examination. In addition, the SYNTAX scores of RT patients were correlated with ESRD duration (p 0.001). Conclusions: We observed less serious CAD in RT patients relative to long-term dialysis patients even though the former group exhibited a longer mean ESRD duration. Both groups exhibited high rates of calcification of the coronary artery, even following RT.