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Cyclooxygenase-2 (COX-2) is an enzyme involved in the production of prostaglandins during inflammation. The aim of this study was to investigate the prevalence of COX-2 gene promoter -765G>C polymorphism in a Greek adult population in relation to coronary artery disease. In total, 102 subjects, 74 men (72.55%) and 28 women (27.45%) (median (range) 55 (36-86) years of age) were recruited. Subjects were divided into two main groups: 69 patients (67.65%) hospitalized for myocardial infarction (MI), 54 (78.26%) of which with elevated ST (STEMI) and 15 (21.74%) without (NSTEMI) (study group). The second group consisted of 33 patients (32.35%) with unstable angina but no history of MI (controls). Serum levels of highly sensitive C-reactive protein (hsCRP) and prostaglandin E2 (PGE2) and COX-2 -765G>C gene promoter polymorphism were determined. Genotype frequencies were 60% for CC, 22% for GC and 18% for GG in the total of subjects participating. Although there were statistically significant higher hsCRP levels in study group than controls (p2 (p=0.455 and p=0.303) between different genotypes in either group, respectively. The onset of acute coronary events does not seem to be related to the -765GàC polymorphism of the COX-2 gene promoter.