OBJECTIVE The pathophysiology of coronary slow flow (CSF) has not been clarified. Salusin-β is released predominantly from the atheroma plaques and influences the pathophysiologic processes of atherosclerosis. Therefore, this study aimed to determine serum salusin-β levels in CSF and its correlation with CSF. METHODS The study included 39 patients with CSF, and the control group (n=42) consisted of consecutive subjects with normal coronary arteriogram. We measured salusin-β and thrombolysis in myocardial infarction frame count (TFC). RESULTS Age, body mass index (BMI), systolic blood pressure, diabetes, hyperlipidemia, and smoking rates were similar (p values>0.05) in both groups. High sensitive C-reactive protein (2.80±1.2 vs. 2.21±1.2 mg/dL, p=0.011), salusin-β [1205 (330-2092) vs. 162 (29-676), pg/ml, p<0.001], corrected TFC of left anterior descending coronary artery (29±9 vs. 19.7±3.7, p<0.001), circumflex artery TFC (25±10 vs. 15±3.2, p<0.001), right coronary artery TFC (28±7.1 vs. 13±3.3, p<0.001), and mean TFC (28±4.4 vs. 16±3.7, p<0.001) were significantly higher in the CSF group. In univariate and multivariate regression analysis, only BMI (unstandardized β±SE=0.178±0.08, p=0.036) and salusin-β levels (unstandardized β±SE=0.006±0.01, p<0.001) were determined as predictors of CSF. There was a good correlation between serum salusin-β and mean TFC values (r=0.564; p<0.001). CONCLUSIONS There is an association between serum salusin-β levels and CSF.