The adipokines, leptin and adiponectin, have a prominent role in the pathogenesis of coronary artery disease (CAD). The inflammatory enzyme, myeloperoxidase (MPO) also has an important role in the pathogenesis of CAD. Association of the adipokines with MPO remains to be resolved in patients with CAD. In this case-control study, 100 patients with CAD and 100 control subjects were appropriately recruited. Angiographic evaluation assigned the presence of CAD. Plasma leptin, adiponectin and MPO concentrations were measured using immunoassay methods. Other conventional cardiovascular risk factors were also recorded. Leptin and MPO concentrations were significantly increased in CAD patients compared to control subjects (25.38 ± 5.91 ng/ml vs. 3.68 ± 1.95 ng/mL and 52.85 ± 12.90 ng/mL vs. 23.00 ± 3.60 ng/mL, P=0.001, respectively). In contrast, adiponectin was significantly decreased in CAD patients compared to control subjects (5.62 ± 1.15 µg/mL vs. 9.25 ± 1.8, P = 0.001). There was a strong positive association between leptin and MPO concentrations only in CAD patients (P = 0.01). In contrast, a significant inverse association was found between adiponectin and MPO concentrations in CAD patients (P = 0.01). The associations also were significant after adjustment for other conventional risk factors (P = 0.001). Considering the presence of significant association between leptin and MPO, as well as adiponectin and MPO in patients with CAD, it may be inferred that the contribution of the adipokines in the pathogenesis of CAD may be, in part, through affecting the MPO concentration.