BACKGROUND: Cardiovascular disease has taken epidemic proportions during past decades. Cardiovascular risk factors contribute to progression of coronary lesions, worsening the patient's prognosis. This study was planned to analyze the association of dietary factors with severity of coronary artery disease (CAD) in Indian patients. METHODS: Three hundred patients with known coronary disease above the age of 25 years were included in this study. Blood samples were collected for biochemical markers. Patients were stratified according to severity of CAD [number of vessel involved-single (SVD), double (DVD), triple (TVD)]. RESULTS: Mean age of the patient was 60.9 ± 12.4 years. Subjects with TVD, DVD, SVD in the study were 52.3%, 25.3% and 22.3% respectively. Patients with TVD had higher body mass index, triglycerides, HOMA-Insulin Resistance, hsCRP and lower high density cholesterol. Diabetes mellitus, hypertension and dyslipidemia were more common in TVD patients. Among macronutrients, patients with TVD had higher intake of carbohydrate and lower intake of protein and dietary fibers. There was no association of total fat intake with CAD, however, intake of palmitic acid was higher among patients with TVD. Intake of vitamins namely niacin, riboflavin, thiamine, B6, and vitamin-C decreased with increase in severity. With increase in severity of CAD, mineral intake (potassium, calcium, magnesium, phosphorus, sulfur, iron, chromium, copper, manganese, and zinc) decreased. CONCLUSIONS: Dietary factors are associated with severity of coronary artery disease. Low intake of protein, fiber, vitamins, minerals and high intake of carbohydrate and fat was associated with higher probability of having severe CAD.