Background: Metabolic syndrome (MetS) is a cluster of metabolic traits that confer high risk for coronary artery disease (CAD). This study aimed to assess the relationship between MetS components and severity of CAD . Methods : Eighty six patients underwent elective coronary angiography, calculation of the metabolic risk score and laboratory evaluation. Patients divided into two groups according to the presence of MetS: group A; 64 patients with ≥ 3MetS components and group B; 22 patients with< 3 components. Assessment of CAD severity using Gensini score. Results:- There were significant difference between the both groups concerning body mass index, high blood pressure, triglyceride, high density lipoprotein, fasting blood glucose (FBG), serum insulin, insulin resistance and Genseni score (P < 0.05) . Significant positive correlation between MetS score and Genseni score (P< 0.000). Multivariate analysis showed that MetS itself did not predict the presence of CAD (p= 0.49), howevere some individual component of MetS show significant predictive value; namely, high FBG > 110 mg/dl ( OR 23.748, p<0.001), high TGs > 150 mg/dl (OR 7.35, p =0.012) and high blood pressure( OR 6.07, p= 0.02). Conclusion: - Fasting blood glucose, high triglyceride and blood pressure were independent predictors CAD rather than metabolic syndrome itself. FBG was the most independent factor that predicts CAD.