The present case-control study evaluated the association of  gene polymorphisms and enzyme activity in the western Indian population. Angiographically proven coronary artery disease (CAD) formed the cases. polymorphisms (Q192R, L55M) and enzymatic activity (paraoxonase) were assessed.  A total of 502 participants (251 per group) were studied. Q192R and L55M polymorphisms were not associated with the risk of CAD. Notably, a weak association was observed between Q192R polymorphisms and the risk of CAD. CAD patients had significantly lower enzymatic activity (U/L) as compared with the controls regardless of the genotype. Low serum activity was confirmed to be an independent predictor for the risk of CAD.