Background:  Fetuin A protein is Alpha 2-Heremans Schmid glycoprotein (AHSG).It acts as negative acute phase reactant synthesized by the liver cells, it is responsible for preventing calcium and phosphate precipitation in the blood by increasing their solubility and inhibiting calcium crystal growth. Deposits of calcium phosphates (hydroxyapatites) in the muscular layer of the blood vessels appear to play not only a significant role in stiffening arteries but also for the induction of an early phase of coronary arteriosclerosis. Fetuin A has been considered to play a crucial role in the protection from vascular calcification by solubilizing calcium and phosphorus in serum. Objective: the aim of this study was to determine the level of fetuin A in some Egyptian patients with coronary artery disease and its correlation with the severity of the disease.  Subjects and methods: sixty Egyptian persons were involved in this study, twenty of them were healthy as a control, other twenty of them were patients with stable angina, the last twenty were patients with acute myocardial infarction. Serum fetuin A, CRP, CK-MB, troponine I, creatnine, lipid profile and blood glucose estimation were performed. In addition, exercise ECG was done for all individuals.  Results: serum fetuin A level decreased in the two groups with coronary artery diseases than the control; it also   markedly decreased in patients with myocardial infarction than both those with stable angina and control.  Conclusion:  This study showed that decreased serum fetuin A level was correlated with the development of coronary artery disease. Fetuin A might be clinically valuable for reflecting the progression of coronary artery disease.