Background: We aimed to compare the predictive value of Neutrophil-to-lymphocyte ratio in patients of CoronaryArteryDisease with healthy persons and to compare the values of NLR among CAD patients with past history of MI and without past history of MI.Methodology: This study was an observational analytical case control study, conducted on 75 cases with CAD and 150 healthy controls reporting to Department of Medicine, People’s College of Medical Sciences& Research Centre and associated People’s Hospital, Bhopal. The study was conducted over the period of 20 months i.e. from 1stNovember 2022 to 30th June 2024. Detailed history was obtained and all the patients were subjected to complete blood examination and NLR was calculated. Results: Mean NLR was found to be significantly higher in cases as compared to control group (p<0.05).NLR is excellent tool for predicting coronary artery disease (AUC-0.944).The best cut off of NLR for predicting CAD was 2.05 with sensitivity and specificity of 89.3% and 76% respectively.Mean NLR in cases with previous history of MI was found to be significantly higher as compared to cases with no previous history of MI. Conclusion: NLR is a simple, cost effective, easily available tool for predicting the risk of CAD. Also, NLR can help in risk stratification in cases with CAD, as observed from high NLR in cases with previous MI as compared to those with no previous history of MI. NLR may help physicians in facilitating early and timely detection of CAD and may aid in initiating early management of the condition.