Aim: Central obesity is associated with an increased cardiovascular risk. We carried out a hospital based case control study in young patients with coronary artery disease (CAD) to assess the importance of visceral fat.Methods: Coronary artery disease was established by coronary angiogram in all cases. Controls were age-and sex-matched subjects with normal coronary angiogram. Computed tomography scan performed at the level of the umbilicus to measure subcutaneous and visceral fat area (VFA).Results: Cases and controls were well matched in height, weight, and body mass index (BMI). Visceral fat area was significantly higher (122.58 ± 37.59 vs. 88.4 ± 36.95 cm 2 ; P = 0.003) in cases whereas subcutaneous fat area was similar in cases and controls. Visceral fat area was an excellent predictor of cardiovascular risk (area under receiver operating characteristics curve 0.915 cm 2 ). Visceral fat area correlated with BMI, waist hip ratio, blood sugar, triglycerides, and C-reactive protein significantly. Conclusion:Visceral adiposity is associated with an increased risk of CAD and it correlated with anthropometric, metabolic, and inflammatory markers.