AbstractIntroduction: Coronary artery anomalies are relatively rare congenital abnormalities that are often found incidentally during coronary catheterisation done for various indications.Aim of the study was to study clinical and angiographic profile of various coronary anomalies in out institute with respect to demographic profile, frequency of coronary anomalies, atherosclerotic coronary artery disease involvement of anomalous coronaries and associated cardiac comorbidities. Methods: In this study total 162 patients who were reported as having coronary anomaly from 2011 January to 2014 March were evaluated. These patients had undergone coronary angiogram for various indications. All patientsdata including demographic profile, clinical presentation, ECG, 2D echo, routine biochemical investigation reports were analysed and angiograms were reviewed. Various coronary anomalies were classified and relative frequency calculated and cardiac comorbidities were analyzed. Results: Out of 25023 coronary angiograms done during study period, 162(0.65%) patients were found to have coronary anomalies. Among 162 patients, 134(82.7%) were male and 28(17.3%) were female. Average age of presentation was 54.4 years. Most of these patients had conventional risk factors like hypertension (33.9), diabetes mellitus (30%), dyslipidaemia (18.5%), smoking (33.3%) and family history of ischemic heart disease(7.4%). 6.7% patients with coronary anomalies had past history of ischemic heart disease. Among 162 patients, 108(66.7%) presented with acute coronary syndrome, 37(22.8%) with chronic stable angina and in 17(10.5%) patients coronary angiogram was done for other indications. Conclusion: Angiographic incidence of coronary anomalies in patients undergoing coronary catheterization in present study is 0.65%. Most of the anomalies were low risk coronary anomalies diagnosed incidentally. Anomalous coronary arteries are frequently involved in atherosclerotic coronary artery disease and have conventional risk factor profile and clinical presentations.