Abstract: AIM: To observe the changes of nailfold microcirculation, hemodynamics, and serum lipid and glucose in patients with coronary artery disease (CAD) for early diagnosis, treatment and prognosis. METHODS: Nailfold microcirculation, hemodynamic and serum lipid and glucose changes were examined in 156 patients with CAD. RESULTS: Compared with those in the control (n=50), density of nailfold vasoloops, diameters of arterial limb of vasoloops and blood flow velocity decreased, whereas the intersection and deformity vasoloops, diameters of venous limb of vasoloops and subpapillary venous plexa density increased. Erythrocytes aggregated greatly and whole blood viscosity, plasma viscosity, ESR, fibrinogen, blood platelet adhesion and aggregation, total cholesterol, triglyceride and serum glucose levels were significantly higher, but the serum level of high-density lipoprotein cholesterol was significantly lower. Nailfold microcirculation and hemodynamics were evidently abnormal in patients with comorbid conditions such as hypertension, diabetes, or/and hyperlipidemia. CONCLUSION: Nailfold microcirculation, hemodynamics, and serum lipid and glucose in patients with CAD are clearly abnormal and the changes are more severe in CAD patients with comorbidiites such as hypertension, diabetes or/and hyperlipidemia.