Background: Coronary artery disease (CAD) is the biggest killerof women globally.CAD among young women as a group is less easily recognized worldwide. Young women are underrepresented in most of theCAD studies. This study assessed Clinical and angiographic profile of CAD in young women of North-East India to have a better understanding of the nature and courseof the disease. Material and Methods:This was a prospective, observational, single centre analytical study. Totalparticipants were divided into 2 groups – young women less than 55 years and old women more than or equal to 55 years.Modes ofpresentation,riskfactors,clinicalandangiographicprofileofCADwere compared. Risk factors studied were smoking, hypertension, diabetes mellitus,dyslipidaemia, obesity and family history of prematureCAD.CADseveritywas assessedby SyntaxscoreandGensiniscore. Results: A total of 143women were studied. Out of these 57 women were <55 years and 86 women were ≥ 55years of age. Hypertensionwasthe mostcommonriskfactor foundin both groups of women followed by diabetes and dyslipidaemia. Most common presentation among youngerwomen were chronic stable anginafollowed by ST elevation myocardial infarction (STEMI). In younger women most of them had normal Left Ventricular Ejection Fraction, 54.4 % vs 41.9% of patients(p=0.04).Younger women had normal coronaries in19.3% vs. 9.3% in older women (p=0.072).Younger women had significantly lower number of multivessel diseases than older women, 29.8% vs 44.18% (p = 0.045). Left Anterior Descending coronary artery (LAD) was the most common coronary artery involved in both groups (43.9% vs 52.3%). Low Syntax score (≤22) and lowGensini score (≤20) were found in younger women 75.4% vs older women 67.4% (p=0.201)and 56.1% vs. 40.7% (p=0.05), respectively. The increase in Syntax and Gensini score with increase in number of risk factors were found to be statistically significant in both the groups. Conclusion: In younger women, most of the patients presented withchronic stable angina and STEMI with a preceding history of angina. Hypertension and diabetes were most common risk factors both being modifiable needsutmost attention for prevention. Coronary angiography revealedless severe CAD in younger women than older women as assessed by coronary severity score.