Coronary Artery Disease (CAD) remains a leading global health challenge. Long non-coding RNAs (lncRNAs) have emerged as promising biomarkers for CAD. A systematic review following PRISMA guidelines evaluated 22 studies to assess long non-coding RNAs (lncRNAs) as biomarkers for Coronary Artery Disease (CAD). Among 27 identified lncRNAs in 5,301 participants, KCNQ1OT1, HIF1A-AS2, and APOA1-AS showed notable diagnostic accuracy, with 100% sensitivity and 80% specificity. One lncRNA, OTTHUMT00000387022, exhibited the highest specificity at 98%. Despite methodological differences, consistent diagnostic relevance was observed across studies, with sensitivity and specificity reaching 100% and 98%, respectively. This review underscores the potential of lncRNAs as CAD biomarkers, with 23 upregulated and 4 downregulated lncRNAs identified. Their stable presence in human biofluids and strong association with CAD suggest their utility as diagnostic markers and potential therapeutic targets.