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Abstract : To study the clinical profile, incidence, and pattern of congenital coronary artery anomalies (CAAs) in adults undergoing coronary angiography. Coronary angiogram of 3600 patients done between September 2017 and September 2021 were reviewed for the presence of CAAs. Angiography data of 3600 patients done between September 2017 to September 2021 was reviewed in the present study and 88 patients were found to have CAAs giving a prevalence of 2.44%. Mean age of patients was found to be 56.86±11.49 years (range 24-75 years). Among these, the anomalous origin and course of the coronaries were the most common anomaly seen in 73 (2.02%) patients, followed by intrinsic anomalies of the coronary arterial system in 13 (0.36%) patients, followed by anomalous coronary termination in 01 patient (0.03%) and single coronary artery 01 patient (0.03%). Overall, the anomalous origin of the right coronary artery (RCA), with RCA arising from left coronary sinus was the most common anomaly seen in 23 patients (0.64%) followed by absence of the left main trunk with a separate origin of the left anterior descending (LAD) and left circumflex artery (LCX) seen in 20 (0.56%) patients. Posterior origin of RCA within right coronary sinus was seen in 13 (0.36%) patients. There were 6 cases of high origin of right coronary artery (RCA) (0.16%). There were 10 patients (0.28%) of LCX arising from right coronary sinus and 01 case of LMCA arising from right coronary sinus. Split RCA was seen in 09 (0.25%) patients whereas split LAD was seen only in 04 (0.11%) patients. Further, there was only 01 (0.03%) patient of anomalous coronary termination (RCA to right atrium fistula) and 01 (0.03%) patient of single coronary artery. The prevalence of congenital coronary anomalies in the study was found to be 2.44%. and commonest anomaly was that of origin and course of the vessels (88%). Though the prevalence of CAAs in this study was similar to that in previous studies, the pattern of anomalies was slightly different from previous studies.