Background: Several scoring systems tried to determine coronary artery stenosis severity to investigate its correlation with laboratory parameters.Aim of the study: To investigate the correlation between the expression levels of circulating miRNA-133a & coronary artery stenosis severity .Patients and Methods: The study was conducted in Medical Biochemistry Department and Cardiology Department - Faculty of Medicine, Zagazig University& Medical Scientific Research Center. It included 72 subjects classified into 2 groups; Group (1): included 18 healthy subjects served as a control. Group (2 included 54 acute coronary syndrome patients. It was subdivided into 3 subgroups each 18 patient: unstable angina , non-ST-segment elevation myocardial infarction and ST-segment elevation myocardial infarction . Plasma miRNA-133a expression level was analyzed by real time PCR. Cardiac Cathetrization was done for showing the severity of stenosis. Results: The present study showed high significant positive correlation between miRNA-133a level and coronary stenosis percentage in unstable angina group (p