In the context of acne vulgaris (AV), which is a prevalent, long-term skin illness, the pilosebaceous units of the skin may become blocked or inflamed, resulting in both inflammatory and noninflammatory lesions, as well as a combination of both. Even the back and chest might be affected by this disease. Acne is one of the most common skin problems among teens, accounting for more than 85% of the population. P. acnes, seborrhea, sebaceous gland hyperplasia, and follicular hyper keratinization all play a role in the pathogenesis of an acne lesion. An increased chance of developing type 2 diabetes, cardiovascular disease (CVD), weight gain, and other health issues is associated with the metabolic syndrome (MetS) or syndrome X. Serum zinc alpha glycoprotein, BMI, and the severity of acne will be examined in this research to see whether there is a correlation. According to the worldwide acne grading system, this research comprised 40 instances of moderate to severe acne vulgaris and 40 healthy control subjects. They were chosen among patients at the Benha University Hospital Dermatology and Andrology Department's Outpatient Clinic. The trial lasted anywhere from six to twelve months. In terms of age, gender, and location, there was no statistically significant difference in any of the three groups tested. P=0.001 showed that cases had a higher mean BMI than controls. As compared to the control group, there was a statistically significant difference (p=0.044). Only 17.5 percent of acne sufferers had mold-related acne, which had a mean age of onset of 13.5 years. In ZAG, there was a statistically significant difference between the two groups tested. ZAG has a negative association with BMI, acne duration, and severity, according to the results of this study. ZAG was shown to have a statistically significant relationship with the severity of acne in the patients who were investigated. Severe cases exhibited lower ZAG than mild and moderate ones.