Background:Antiphospholipid syndrome (APS) is an autoimmune condition characterized by high levels of antiphospholipid antibodies, which increase the risk of fetal loss, arterial and venous thrombosis. Neutrophils have long been observed in thrombi, but the specific mechanisms by which they contribute to thrombus development remain unclear. Objective: To evaluate the role of neutrophils in enhancement of thrombotic risk in patients with primary antiphospholipid syndrome. Material and Methods: 60 patients with primary APS participated in this study, along with 30 age- and sex-matched healthy volunteers serving as the control group. 30 patients in the patient group had prior thrombotic events, and 30 patients had no prior thrombotic events. The enzyme-linked immunosorbent assay was used to measure the lupus anticoagulant, anticardiolipin antibodies, anti-B2 glycoprotein, matrix metalloproteinase -2(MMP-2), monocyte chemoattractant protein-1(McP-1), and citrullinated histone (H3cit). While spectrophotometry was used to assess myeloperoxidase (MPO) activity. Result: In groups I and II, the patients' mean ages were (42.93± 7.15) and (42.70± 8.30), respectively. The disease duration was (5.25 ±2.7 years) in group I and (5.54± 2.9 years) in group II. The recruited patients were distributed between the two groups, with 39 females and 21 males. Regarding MPO activity, MMP2, McP1, and H3cit, there was a significant difference between APS patients with prior thrombotic events and APS without such events, as well as between both groups and control. Conclusion: Since neutrophil activation pathways are major regulators of both arterial and venous thrombosis, APS patients may benefit from medications that target these pathways to prevent thrombosis.