Microalbuminuria has emerged as an important risk factor of considerable prognostic importance for cardiovascular events. Little is known about its impact on the angiographic profile among coronary artery disease patients. The primary aim of the study was to investigate the relationship of microalbuminuria and angiographic severity of coronary artery disease. This was a cross-sectional study conducted in NICVD, a tertiary-care cardiac center in Dhaka, Bangladesh. For this purpose, 72 patients aged 25 to 70 years, who underwent elective coronary angiogram were studied. Urinary albumin to creatinine ratio was used as a measure of microalbuminuria. Angiographic severity of coronary artery disease was measured by number of major vessels involved (vessel score), stenosis score, extent score and number of type B and C lesions. All parameters of angiographic severity were significantly higher in microalbuminuric patients. Spearman's rank correlation coefficient showed significant positive correlation between albumin to creatinine ratio and different parameters of angiographic severity. In multivariate logistic regression analysis odds ratio of having triple vessel coronary artery disease in microalbuminuric patients was 5.6 (95% CI, 1.4 - 22). Microalbuminuria was found to correlate positively and independently with angiographic severity of coronary artery disease.