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Background and objective: We aimed to investigate biochemical factors affecting coronary collateral circulation development in an elderly population aged 75 years and over. Material and methods: The study group consisted of patients with a prior coronary angiography for stable coronary artery disease (CAD). Patients with total occlusion of at least one vessel were included in the study. Enrolled patients were divided into two groups, good collateral (GC; n = 73) and bad collateral (BC; n = 55), in accordance with the Cohen-Rentop's classification system. Results: In comparison to the GC group, bilirubin levels were significantly lower (p < 0.001), and fasting plasma glucose (FPG) levels were significantly higher in the BC group (p = 0.026). Low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in the BC group when compared to the GC group (p = 0.002 and p < 0.001, respectively). Backward elimination stepwise logistic regression analysis identified bilirubin and FPG as variables that strongly predicted the presence of a well-developed coronary collateral circulation and a poorly developed coronary collateral circulation, respectively. Conclusion: Bilirubin and FPG were seemed as the most important factors affecting coronary collateral circulation development in patients with stable CAD who were older than 75 years.