The low serum level of testosterone in the elderly subjects may be a contributing factor for coronary artery disease (CAD) through many pathways.The aim of this work is to study serum levels of free testosterone in elderly men with CAD (both those with acute coronary syndrome (ACS) and those with stable CAD). This study was conducted on 100 elderly males with CAD ,one half of them (50 patients) was presented with ACS (with mean age 69.6± 2.44 year), and the other half (50 patients) was presented with stable CAD (with mean age 69.42± 2.14year), in addition to 50 apparently healthy elderly males (with mean age 69.06 ± 1.64year) as a control group. We detected the levels of serum free testosterone, cortisol, fibrinogen, plasminogen activator inhibitor-1(PAI-1), high sensitive C-reactive protein(hsCRP), interleukin-6(IL-6). Cases with CAD had significant lower values of free testosterone and HDL-c, but they had significant higher values of cortisol, fibrinogen, PAI-1, IL-6, hsCRP, in comparison to control group. Cases with ACS had significant higher values of cortisol, hsCRP, IL-6, fibrinogen, PAI-1, total cholesterol and BMI more than those with stable CAD. The free testosterone had significant negative correlation with fibrinogen, PAI-1, , hsCRP and IL-6 in both groups of patients. The lower value of serum free testosterone in elderly male subjects may contribute to CAD in them via multiple mechanisms including increase blood pressure, dyslipidemia, obesity, increased blood coagulation and increased inflammatory activity.