Objective: This study aimed to determine the levels of Alanine Aminotransferase (ALT) in patients with Coronary Heart Disease (CHD) and examine the relationship between ALT levels and the presence and severity of CHD. Study Design, Place, and Duration: A cross-sectional study was conducted by the Institute of Medical Lab Technology, Isra University Islamabad, in collaboration with DHQ Hospital, Jhelum, and Premium Diagnostic Lab, Rawalpindi, from October 1, 2023, to December 31, 2023. Methodology: We collected 3ml blood samples from 100 CHD patients and 100 healthy controls. Samples were analyzed using the Roche Cobas Model C311. Demographic and clinical data (age, gender, diabetes, smoking, family history) were recorded. Data analysis was performed using SPSS version 25. Results: The mean ALT level was 36 U/L in the control group and 196 U/L in the CHD group. The standard deviation was 23.7 for the control group and 544.8 for the CHD group. Conclusion: The study confirmed that CHD is associated with factors like type 2 diabetes, dyslipidemia, smoking, and family history. Elevated AST and ALT levels are significant risk factors for CHD. Lifestyle changes, such as a balanced diet and smoking cessation, can help prevent CHD. ALT and AST may serve as independent predictors for early CHD diagnosis and prevention.