Abstract Metabolic syndrome is a group of simultaneous conditions that expanding your risk of heart disease, stroke, and type 2 diabetes. These conditions include increased blood pressure, high glucose level, and abundance muscle versus fat around the abdomen or triglyceride levels. The objective of the study is to demographic, biochemical, obesity indices and angiographic profile (severity of CAD) of patients with coronary artery disease (CAD). A prospective and observational study involving a number of 971 patients who had undergone coronary angiogram (CAG) for the 18-month CAD assessment. In present study about half of population had significant abnormality on coronary angiogram. Amongst abnormal coronary angiogram about 50% of patients had single vessel disease. The FRS had positive correlation with severity of coronary artery disease and waist circumference. FRS and metabolic syndrome had critical contribution as score and risk factors with presence of and severity of CAD. To conclude it was suggested to incorporate FRS and components of metabolic syndrome for better management and risk stratification of coronary artery disease at large.