<p>Background: Coronary artery disease (CAD) severity is influenced by metabolic and biochemical risk factors, which may differ by sex. The present study evaluated sex-based differences in biochemical and anthropometric parameters across single-, double-, and triple-vessel CAD. Methods: This cross-sectional study included 100 adults with angiographically confirmed CAD. Based on coronary angiography, patients were classified as having single-vessel disease (SVD), double-vessel disease (DVD), or triple-vessel disease (TVD). Data analysis was performed using independent t-tests. A p-value &lt; 0.05 was considered statistically significant. Results: Multivessel disease was highly prevalent, with DVD observed in 66% and TVD in 88% participants. Family history was significantly more common in males (p &lt; 0.01), while females had higher BMI (p &lt; 0.05) and greater prevalence of diabetes (p &lt; 0.05). A sedentary lifestyle was more frequent in males (p &lt; 0.01). The lipid parameters did not differ significantly by sex, but HbA1c was higher in females (p &lt; 0.05). In the severity-stratified analysis, significant sex specific changes were observed. In females, LDL was higher in SVD and HDL was lower in TVD (p &lt; 0.01). In males, HbA1c was higher in TVD (p &lt; 0.05). HbA1c differed significantly between sexes in patients with DVD (p &lt; 0.05). Troponin I levels were significantly elevated in TVD compared to non-TVD participants in both sexes (p &lt; 0.01) but not in SVD and DVD. Conclusion: Glycemic markers and lipid parameters show a differential pattern with vessel involvement in men and women, while troponin-I is strongly associated with multivessel disease irrespective of sex. These findings support the importance of incorporating sex-specific metabolic assessment in the management of CAD patients.</p>