Coronary artery disease has been a number one killer worldwide and in India it has increased phenomenally as the most important cause of sudden natural death of cardiac aetiology in the last few decades. Changing lifestyles, stress, habits, presence of other predisposing pathologies etc have played direct as well as indirect roles in its causation. Conventionally the predictors for coronary artery disease have been predominantly risk factors. Notwithstanding this, of recently a number of extra cardio vascular physical parameters like ear lobe crease have shown a reasonably promising trend in predicting the presence of coronary artery disease thereby enabling prompt intervention which in turn can reduce cardiac mortality in the long run. The present study focuses on this aspect of detecting an association between diagonal ear lobe crease and sudden death due to coronary artery disease. A total of 188 cases brought for medicolegal autopsy was studied. It has been revealed that diagonal ear lobe crease detected at autopsy has a statistically significant association with both the presence of coronary artery disease as well as the severity of atheromatous occlusion in sudden deaths. Hence diagonal ear lobe crease can have a reasonable predictive value in detecting coronary artery disease that could be used for the early detection of individuals with coronary artery disease and thus pave the way for early interventional strategies.