Background: Ischemic Ischemic heart disease [IHD] is a leading cause of hospitalizations and visits to the emergency room. Rupture of atherosclerotic plaques and coronary artery thrombosis, either whole or partial, are typical symptoms of IHD. This research set out to compare the SYNTAX score [SX score] with the value of immature granulocyte in predicting the severity of coronary artery disease in ischemic heart disease patients having coronary angiography at Benha University. Included were 200 individuals who had coronary artery disease. Patients with cancer, inflammatory bowel disease, chronic renal failure, chronic liver failure, heart failure, being under the age of 18, pregnant, or using steroids or immunosuppressive drugs were excluded. The results showed that hypertension, heart rate, LDL and triglyceride levels, and HDL levels were all lower in patients with high granulocytes. The amount of granulocytes was significantly correlated with other inflammatory indicators [p value < 0.05]. Complex coronary vasculature and a high syntax score were both linked to a high granulocyte level.