BACKGROUND: Lack of information about clinical symptoms and risk factors of coronary artery tortuosity prompted us to perform this study to compare patients with and without coronary artery tortuosity. METHODS: Among patients with chronic stable angina who underwent coronary angiography, we selected 98 patients with coronary tortuosity. They were retrospectively compared with 98 chronic stable angina patients without tortuosity to determine clinical symptom, risk factors, and angiography findings via Gensini score. RESULTS: In this study, 68.4% of patients with coronary tortuosity were female (P = 0.001). The mean age in this group was 59.2 years compared to 53.9 years in patients without tortuosity (P = 0.001). More than 7 clinical symptoms despite less coronary stenosis were found in tortuous coronary group. Among cardiovascular risk factors, only diabetes was significantly more common in the non-tortuous coronary group. CONCLUSION: This study concluded that coronary tortuosity is more common in the elderly and among female gender. Diabetic patients may have less prevalence of tortuosity. Further studies may provide more data about the cause and better management of the higher number of clinical symptoms in these patients despite their less epicardial artery stenosis. Keywords: Coronary Tortusity, Clinical Symptoms, Risk Factors.