Background: Distribution of body fat is known to be more independent and potent predictor of morbidity and mortality than total body adiposity, individuals with abdominal obesity are at a great risk for developing type 2 diabetes mellitus and atherosclerotic cardiovascular disease. Apelin could be considered a ‘good’ adipokine when considering cardiovascular disease. It reduces atherogenesis, macrophage inflammation, mean arterial pressure, cardiomyocyte contractility, atrial fibrillation and heart failure. Objectives: To assess the impact of visceral obesity and plasma level of apelin on coronary artery disease in Egyptian patients. Patients and methods: A total of 371 patients were recruited in this observational study, mean age was (53.6± 9), males were 229(61.7%) and 142(38.3%) were females scheduled for elective coronary angiography in Kaser alainy teaching hospital and national heart institute for the period between December 2012 and May 2013. All patients were subjected to thorough history taking including sex, history of smoking, diabetes, hypertension and family history of coronary artery disease, reason for coronary angiography and any previous history of peripheral vascular disease, myocardial infarction , congestive heart failure, chronic obstructive pulmonary disease, analysis of lipid profile, measurement of serum creatinine and fasting plasma glucose, plasma level of apelin standard transthoracic echocardiogram, as well as measurement of body mass index, waist circumference, waist hip ratio and waist height ratio. Obesity was defined as body mass index ≥30 kg/m2, waist circumference≥ 94cm for men and ≥ 80 cm for women, waist height ratio ≥0.5 and waist hip ratio ≥0.85 in females and ≥0.90 in males. Results: There was no significant difference between obese and non obese patients as regarding Gensini score ,most probably due to small sample size . Plasma apelin level did not show significant difference between groups. Body mass index correlated significantly with total cholesterol ( r=0.140, p=0.012) and with LDL-C ( r =0.132, p= 0.018) , body mass index was also correlated with plasma apelin level (r=0.232, p= 0.039) , waist circumference correlated significantly with total cholesterol (r = 0.150 , P= 0.007) , waist height ratio correlated significantly with total cholesterol (r = 0.183 , p= 0.001) and with LDL-C (r = 0.140 , p= 0.012). Conclusion: We concluded in our study that there no difference was found in plasma apelin between obese and non obese patients and no correlation between apelin and Gensini score. Also females was predominant in obese group. There was an increase in cardiovascular risk factors among obese Egyptian patients