Introduction : Obesity, metabolic syndrome and diabetes mellitus are risk factor of coronary artery disease (CAD). Fibroblast growth factor 21 (FGF21) is secreted primarily from liver that exerts potent anti-diabetic and lipid lowering effects in animal models of obesity and type 2 diabetes mellitus. In recent studies showed FGF21 has similar effects in human subjects and also related with obesity and metabolic syndrome. However, the relationship between serum FGF21 level and CAD is not yet unknown. Objective : This study aimed to investigate the relationship among serum FGF21 levels, various cardiometabolic parameters and CAD in type 2 diabetic patients. Methods : In a total of 168 Korean adults with diabetes mellitus, in whom coronary angiogram were performed and classified into CAD group (n = 99) and non-CAD group (n = 69). Significant coronary artery stenosis was defiened as a coronary angiography finding of more than 50% stenosis in 1 ��� coronary arteries. Fasting serum FGF21 level were measured using ELISA. Results: Serum mean FGF21 level in type 2 diabetes mellitus with CAD showed lower than in type 2 diabetes mellitus without CAD (1.10 짹 0.22 pg/mL vs. 1.27 짹 0.16 pg/mL, P < 0.05). Conclusions: The results suggest that fasting serum FGF21 levels might be a predictive marker of coronary artery diseases in Korean patients with type 2 diabetes mellitus.