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Abstract Coronary heart disease (CHD) is the leading cause of death worldwide. Tobacco use is the major cause of many of the world’s top fatal diseases including cardiovascular disease. CYP1A1 is the main metabolizing enzyme of polycyclic aromatic hydrocarbons (PAHs) which is one of the key toxic components produced during cigarette smoking. PAHs generates a highly electrophilic diol-epoxide metabolite capable of creating DNA adducts. Several single nucleotide variations in CYP1A1 gene have been identified from past few years. One of them is, rs4646903 (T6235C) in the 3΄-flanking region, has been associated with increased transcript half-life and therefore increased enzyme activity resulting in elevated levels of activate metabolites. This study aimed to evaluate the association of CYP1A1 (T6235C) polymorphism with the risk of developing acute coronary syndrome and evaluate the potential effect of the smoking habit on this association. This study included 15 cigarette smoking male patients with acute coronary syndrome (ACS) and 15 non cigarette smoking patients with acute coronary syndrome (ACS). These patients were selected from the out and in patient clinic of Medical Cardiology Department |