Introduction- Coronary artery ectasia and aneurysm is an uncommon angiographic finding, which involves a part or complete length of the coronary artery. It leads to significant cardiovascular outcomes and is considered a risk factor for coronary artery thrombosis. This study aims to evaluate the prevalence of coronary artery ectasia and aneurysm, their segmental involvement, and clinical presentation in patients with and without coronary artery disease (CAD). Material and methods- We did a cross-sectional, retrospective analysis of 1764 coronary angiograms performed between July 2019 to June 2020. Segmental involvement of coronary artery ectasia and aneurysm is studied in patients with and without CAD. Results- Prevalence of isolated aneurysm was 1.1%, isolated ectasiawas 20.2%, and ectasia with the aneurysm was 2.9%. Prevalence of aneurysm was similar between CAD and non-CAD group (1.2 vs. 1.1%, p < 1.000). Prevalence of aneurysm with ectasia was also similar between CAD and non-CAD groups (2.9 vs. 3.2%, p = 0.785). The prevalence of isolated ectasia was more in the CAD vs. non-CAD group ( 22 vs. 13.7%, p < 0.001). Most commonly, coronary artery aneurysm and ectasia are presented as NSTEMI (non-ST elevation myocardial infarction) followed by STEMI (ST-elevation myocardial infarction). Conclusion- Coronary artery ectasia is more common than aneurysms. Isolated coronary ectasiawas prevalent in patients with coexisting coronary artery disease, unlike the aneurysm. Coronary artery ectasia and aneurysm most commonly presented as NSTEMI, followed by STEMI.