Introduction: The coronary atherosclerosis is one of the common diseases in elders. Now it is growing fast among young age group in developing countries. The purpose of this study is to analyze the changing epidemiological trends and prognosis of CAD in young population. Material and Method: This study was conducted from January 2016 to June 2017 at Department of Pathology, B.J. Medical College, Ahmedabad, Gujarat. This is a retrospective study. Data taken from autopsy section, B.J. Medical college, Ahmedabad. Result: A total of 708 autopsy cases were studied. In the study 536 (75.7%) were males and 172 (24.3%) were females. Among them 260(48.5%) males and 128(74.5%) females below 40 years of age had coronary artery lesions. Most commonly involved coronary artery was Left coronary artery. Conclusion: The study showed alarmingly high prevalence of Atherosclerosis in young age. So screening for the same should begin at an early age. The incidence of atherosclerosis is more common in males compared to females; though coronary atherosclerosis is an important risk factor for IHDs in both sex.