TLR4 are intensely expressed in atherosclerotic vessel wall in human and play an important role in the pathogenesis of atherosclerotic vascular diseases. Adiponectin has protective activity against atherosclerosis and inflammation, in humans, low plasma adiponectin levels have been associated with coronary artery disease. Therefore, evaluation of Toll-like receptor 4 expression on peripheral blood monocytes and measurement of serum adiponectin level in patients with CAD were done to determine the role of TLR-4 in the development CAD and the relation of serum adiponectin level to risk factors of the disease.