Background: Obesity is related to multiple risk factors of cardiovascular disease (CVD) including hypertension, diabetes mellitus (DM), metabolic syndrome, and dyslipidemia, while also likely being an independent risk factor for CVD. Through multiple pathways including increased angiotensin, circulating blood volume, and total peripheral resistance, excess weight increases hypertension (HTN) risk. Objective: This study aimed to reveal the relationship between body weight and the severity of coronary artery disease (CAD) in patients referred for coronary angiography at Sohag University Hospital. Patients and methods: This was a cross-sectional hospital-based study performed on 200 patients, at Sohag University Hospital. Mean age was 56.94 ± 10.30 years. Among them, there were 175 patients (87.5%) who were overweight or obese with higher prevalence of HTN, hyperlipidemia, and diabetes. Normal weight patients were 25 (12.5%) with lower prevalence of HTN, hyperlipidemia, and diabetes. Results: According to BMI in our study, 175 patients (87.5 %) were overweight or obese, 162 patients (92.57%) of the overweight had significant coronary artery disease. 162 patients (81%) had significant coronary angiography findings (> 70% stenosis in any of the coronary arteries). They were classified to 63 patients (31.5%) had single vessel diseased, 53 patients (26.5%) had two vessels diseased, and 46 patients (23%) had three vessels diseased. Conclusion: Obesity, diabetes, hypertension, hyperlipidemia, aging and male gender were correlated with severity of CAD. Thus, reduction of weight, stoppage of smoking and control of diabetes, hypertension and hyperlipidemia will improve outcome of coronary artery disease.