Platelets play a key role in the development and progression of atherosclerosis. Platelet volume is an indicator of platelet activation and function, and it can be assessed by platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and Platelet-large cell ratio (P-LCR). PVI are potentially useful markers for the prediction of acute coronary syndromes. Thus our study aims to evaluate the relationship between them and clinical features of coronary artery disease (CAD). Our population is represented by 60 patients undergoing coronary angiography at Al- Assad University Hospital, Lattakia, Syria. Patients were evenly divided into four groups according to their clinical presentation; control group, stable angina group, unstable angina group, and acute myocardial infarction (MI) group. PVI were measured in all patients. We found a significant increase in MPV (P=0.04), PDW (P=0.03), and P-LCR (P=0.03) in patients compared to healthy control subjects. We calculated the cutoff points of these indices to help diagnosing the progressive atherosclerotic plague, P-LCR>28.7% (P=0.01) [sensitivity 44%, specificity 93%], and diagnosing MI, PDW>13.8 (P=0.01) [53%, 100%], MPV>10.4 (P=0.004) [60%, 93%], P-LCR>28.7 (P=0.003) [66%, 93%]. In conclusion, PVI are simple and easy methods that can be used as a predictive marker in CAD patients.