Background: Ischemia modified albumin (IMA) is a novel marker of ischemia that is produced when circulating serum albumin contacts ischemic heart tissues. IMA rises in patients who develop myocardial ischemia during percutaneous coronary intervention (PCI). Objective: To compare blood levels of IMA in angina patients before and after elective PCI. Patients and methods: This case-control study was conducted during the period from July 2020 to March 2021 on eighty patients with single-vessel coronary artery disease in Military Medical Center at Maadi. Forty five consecutive chronic stable angina patients undergoing PCI for management of single-vessel coronary artery disease included in group (I), and 45 Patients undergoing diagnostic angiography with coronary artery disease included in group (II) (control group). Results: There was a statistically significant difference between the studied groups regarding IMA levels. There were statistically significant relations of IMA with TIMI level and occurrence of dissection between the studied patients. The best cut-off of IMA in prediction of TIMI II among the studied patients was ≥ 21. The best cutoff of IMA in prediction of no reflow was ≥ 26.5. Regarding the prediction of dissection, the best cutoff of IMA among the studied patients was ≥ 26.5. There were statistically significant positive correlations between IMA levels and all of diastolic blood pressure, predilation ischemic time, deployment ischemic time, total ischemic time and number of stent inserted. Only total ischemic time was significantly independently associated with IMA levels. Conclusion: IMA is a new sensitive biomarker of PCI-induced ischemia in the PCI setting and may have a role in clinical practice.