Acute coronary syndrome (ACS) is an insufficient supply of the myocardium with oxygenated blood in which atherosclerosis is an essential cause of myocardial ischemia. ACS is a leading cause of mortality and morbidity worldwide, so the aims of our study are to evaluate the correlation between serum vaspin and lipid profile, age, gender, body mass index (BMI), and blood pressure in Iraqi patients with ACS; and validate the hypothesis that a low serum vaspin level serves as an indicator of patients with ACS. Our case-control study included a total of 100 individuals; 75 patients with ACS and 25 healthy controls. A total of 75 patients with ACS (50 male, 25 female) as well as 25 patients with STEMI, 25 patients with NSTEMI, and 25 patients with unstable angina (UA) were enrolled in our study. The mean age and BMI of patients were 54.6 years and 29.5 kg/m2, respectively. All were diagnosed by physicians and taken from the Coronary Care Unit at AL-Yarmouk Teaching Hospital (Baghdad). Venous blood used for measuring serum vaspin, total cholesterol, HDL-VLDL and LDL-cholesterol, triglyceride, and BMI was calculated and also BP was measured. Our results showed that serum vaspin levels were significantly lower in patient groups, while total triglyceride and VLDL-cholesterol levels were significantly higher in patients with ACS than controls. A negatively significant correlation was found between serum vaspin with BMI and total cholesterol. We concluded that serum vaspin showed significant changes with the development and progression of ACS and would be valuable in the assessment of patients with ACS. Vaspin may be used as a predictor of ACS.