Objectives: Coronary atherosclerosis is a progressive degenerative disease and is associated with significant myocardial damage and thus with increased mortality and morbidity. Trace elements are essential for sustained metabolism in healthy individuals, and a delicate balance is achieved in the body. In this study, we aimed to investigate the relationship between serum essential elements, including copper (Cu), zinc (Zn), and chromium (Cr) levels, and angiographic progression of atherosclerosis in patients with coronary artery disease. Materials and methods: This was a single-center, observational study. Among all patients, 80 patients who had more than a 2-month time interval between two coronary angiographies due to clinical indications were included in the study. Venous blood was obtained for the evaluation of the Zn, Cu, and Cr levels before coronary angiographic study. Results: The mean serum levels of Cr were significantly lower in the progression group than in the nonprogression group (0.0797 +/- 0.0287 mg/L vs. 0.0937 +/- 0.0325 mg/L, p = 0.045). Additionally, the mean serum levels of copper were significantly higher in the progression group than in the nonprogression group (1.287 +/- 0.369 mg/L vs. 1.074 +/- 0.374 mg/L, p = 0.013). There were no significant differences in serum levels of Zn between the two groups (0.241 +/- 0.205 vs. 0.230 +/- 0.138, p = 0.796). Conclusion: Plasma heavy metal levels are associated with progression of atherosclerosis. The levels of these trace elements may be an early indicator of an atherosclerotic progression that may potentially occur later on in the disease process.