Objective：To explore the correlation between the fat attenuation index（FAI）and plaque quantification parameters with brain white matter hyperintensities（WMH）. Methods：A retrospective collection of clinical，coronary computed tomography angiography（CCTA）and brain magnetic resonance imaging（MRI）data of 407 patients from January 2021 and December 2022 was conducted. The severity of WMH was assessed using the Fazekas score，dividing patients into mild WMH group（Fazekas score 0-2） and moderate to severe WMH group（Fazekas score 3-6）. Clinical data，FAI，and plaque quantification parameters of the two groups were compared to identify independent risk factors for moderate to severe WMH. Results：There were statistically significant differences in FAI and plaque quantification parameters between the two groups（P ＜ 0.05）. The results of multivariable logistic regression showed that age（OR=1.116，95%CI：1.074-1.160，P ＜ 0.001），coronary artery disease（OR=2.737，95%CI：1.270-6.017，P= 0.010），plaque burden（OR=4.142，95%CI：1.228-13.977，P=0.022），and FAI ＞-70.1 HU（OR=5.089，95%CI：1.899-13.640，P= 0.001）were independent influencing factors for moderate to severe WMH. Conclusion：Older age，presence of coronary artery disease， higher plaque burden，and FAI＞-70.1 HU are associated with a higher likelihood of developing moderate to severe WMH，providing a theoretical basis for the joint management of coronary atherosclerosis and WMH.