Background: Epicedial fat tissue is known as a risk factor in cardiovascular diseases. This study was designed to compare the epicedial fat thickness in patients with cardiovascular diseases and normal patients. It also tried to find a correlation between epicedial fat thickness and severity of coronary stenosis.Methods: This study was conducted from September 2010 to April 2011 at two university hospitals (Noor and Chamran Referral centers) associated to Isfahan University of Medical Sciences, Isfahan, Iran.A total number of 196 subjects were allocate to three groups of control (n=68), acute coronary syndrome (n=64) and chronic stable angina (n=64). After registering demographic data, all individuals underwent echocardiography in diastolic subcostal view to determine the epicedial fat thickness.Angiography was also conducted to assess the severity of coronary stenosis. The thickness of epicedial fat was compared between groups and its correlations with age, sex, hypertension, hypercholesterolemia, diabetes, waist circumference, body mass index and severity of coronary stenosis were evaluated.Findings: The mean age of participants was 59.54±11.01 years. There were statistical differences between age, sex, smoking and severity of coronary stenosis (P<0.001, P=0.03, P=0.04, and P<0.001, respectively). The mean of epicedial fat thickness in acute coronary syndrome, chronic stable angina and control groups were 5.7±2.1, 6.2±2.0 and 4.6±1.9 mm (P<0.001). There were no independent correlation between predicting factors and epicedial fat thickness (P>0.05).Conclusion: This study indicated the thickness of epicedial fat to be more in cardiovascular diseases compared with normal persons. Future studies for evaluating the sensitivity and specificity of this diagnostic method are warranted.