Several studies had indicated that the earlobe crease may be a marker of coronary artery disease (CAD). This prospective study of 261 consecutive men undergoing coronary arteriography was carried out to evaluate the association of the earlobe crease with the presence and extent of CAD. A positive earlobe crease was detected in 67% of this population. When examining the presence of CAD in men with (n = 175) and without (n = 86) an earlobe crease, 85% of those with and 85% of those without an earlobe crease showed some degree of CAD. Since the prevalence of an earlobe crease increased with advancing age, we examined the age-specific prevalence rates of CAD in men with and without an earlobe crease and found no significant differences in those rates. A similar lack of association between earlobe crease and CAD was seen when we simultaneously controlled for other potentially confounding factors. We conclude that the reported association between earlobe crease and CAD is due to the fact that the prevalence of earlobe crease and CAD each increase with age.