Background: The diagonal earlobe crease (DELC) has been linked to coronary artery disease (CAD). There are limited data, regarding it, in Indian patients with CAD. The present study was done to evaluate the prevalence of DELC in Indian patients with CAD. Methods: This cross-sectional study recruited 255 CAD patients who underwent coronary angiography at our center. After taking data of traditional CAD risk factors, patients were evaluated for the presence or absence of DELC. Results: The prevalence of DELC in Indian patients with CAD was 41.2%. CAD patients, in whom DELC was present, had significantly higher prevalence of smoking and hypertension (P = 0.03 and P< 0.0001, respectively). The prevalence of diabetes mellitus, dyslipidemia, and family history of premature CAD was not significantly different in CAD patients with or without DELC. There was also a higher prevalence of significant CAD and multivessel involvement (P = 0.02 and P = 0.0002, respectively) among CAD patients having DELC. Conclusion: DELC was observed in nearly 41.2% of Indian patients with CAD. The presence of DELC may be a marker of high-risk CAD patient.