Introduction:The coronary arteries may present several anomalies, in terms of both number and position. New image-based diagnostic techniques have led to greater reliability in the identification of these anomalies.Aim of the work:this work is done to study the angiographic pattern of normal coronary arteries variations by using the diagnostic catheter.Material and Methods: Any patient enlisted for angiography in catheterization lab in Zagazig University Hospital was enrolled in this study.Results: Data of 4246 patients who underwent coronary angiography were analysed. 115 patients who had anomalous of coronary arteries were entered into final data analysis.The following data could be concluded: The overall incidence of primary congenital coronary anomalies was 2.7% (115 out of 4,246 patients) in our angiographic population, of whom 86 were males (74.7%) and 29 were females (25.3%). The mean age was (45.95 ± 11.65) years. Anomalous LCX was the most common coronary anomaly being present in 35 patients (0.82%). The second most common anomaly was myocardial bridge and it was present in 31 patients (0.73%). Anomalous RCA was present in eighteen patients (15.65%). Left main coronary artery was absent in two cases (1.7%) and it has anomalous origin from right coronary sinus (RCS) in another two cases (1.7%). On the other hand, anomalous LAD was present in 8 patients (6.95 %). Coronary aneurysms were observed in 10 cases (7.82%). On the other hand, coronary fistulas were diagnosed in nine cases (8.7%). The incidence of coronary anomalies among cases with coronary artery detected disease was 72.2% (83 cases) while this incidence among those without angiographically detected coronary artery disease was 27.8% (32 cases). Hence, the frequency of coronary artery anomaly was significantly higher among patients with CAD than those without CAD (P < 0.0001). Conclusion:Coronary artery anomaly is a common anomaly between the populations. It could be the only cause of chest pain without significant coronary lesion.