Background: Cardiovascular disease (CVD) is a primary cause of global mortality, with hypertension identified as a powerful, independent risk factor (Mahmood et al., 2014). Inflammation is critical in all phases of atherogenesis. While C-Reactive Protein (CRP) is a recognized inflammatory marker, Mannose-Binding Lectin (MBL) is increasingly scrutinized for its role in the complement-mediated vascular damage that characterizes coronary artery disease (CAD) (Smith, J.,2020). Aim & Objectives: This study evaluated serum levels of MBL and CRP in hypertensive patients with and without recent myocardial infarction (MI). The objective was to assess whether MBL offers superior or complementary diagnostic value compared to CRP in identifying the presence of CAD in hypertensive patients. Materials & Methods: A cross-sectional case-control study was conducted with 180 subjects divided into three groups: Group A (Hypertension, n=60), Group B (Hypertension with recent MI, n=60), and Group C (Healthy controls, n=60). Serum MBL was quantified via ELISA (Enzyme-Linked Immunosorbent Assay) and CRP was measured using particle-enhanced immunoturbidimetry. Results: MBL and CRP levels were significantly higher in hypertensive patients and peaked in those with recent MI compared to controls (p < 0.001). A significant positive correlation (r = 0.66, p = 0.01) was observed between MBL and CRP specifically in the MI group. Furthermore, Random Forest modeling identified MBL as a powerful non-linear predictor of MI, demonstrating a sharp threshold effect at 800–1000 ng/mL. Conclusion: Both MBL and CRP are elevated in hypertensive patients. However, MBL serves as a more specific marker for advanced subclinical atherosclerosis and MI risk due to its unique non-linear threshold behavior.