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Abstract Acute coronary syndrome (ACS) encompasses a spectrum of clinical disorders of myocardial ischemia or infarction, and still the first cause of death in the world. Despite Troponin is considered the gold standard in diagnosis of ACS, several molecules have been investigated to identify predictive biomarkers of diagnosis. Among these, Galectin-3 has emerged as a promising diagnostic biomarker of ACS. This case-control observational study was conducted on 72 patients with acute coronary syndrome (patient group I) and 20 age and sex matched individuals (control group II) presented to menoufia university hospitals and National Heart Institute during the period from march 2018 till september 2018. We aimed to evaluate the levels of galectin-3 in patients with acute coronary syndrome (ACS) and the relation of galectin-3 to severity of coronary artery disease by using gensini score and with the number of involved vessels. Galectin-3 levels were measured on admission by using commercial ELISA kit. The mean age of study groups was 55.9 ± 11.9 and 68 subjects (73.9%) of the study were male. Compared to control group, median galectin-3 levels were significantly higher in ACS patients (20.25 (11.9 – 39.0) vs. 8.9 (4.6-24.8) ng/mL and P = 0.001). Patients were classified into three groups according to the number of involved vessels. The median galectin-3 levels were significantly different among groups (29 patients with one vessel involved: 18.9 ng/ml (12 –35.2), 27 patients with two vessels |