Coronary artery disease (CAD) is a significant health concern among females, and understanding its modes of presentation and clinical profile is crucial for effective management. This prospective cross-sectional study was conducted at the Department of General Medicine, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, from May 2022 to April 2023. The study aimed to explore the various modes of presentation and clinical characteristics of CAD in females. The inclusion criteria consisted of female patients above 40 years with hypertension, diabetes mellitus, and dyslipidemia, while patients with congenital heart disease, rheumatic heart disease, structural heart disease, or electrical abnormalities were excluded. A total of 100 female patients presenting with symptoms, signs, and electrocardiogram (ECG) changes suggestive of CAD, along with elevated biochemical markers, were included as cases. The results revealed that 33% of the patients belonged to the age group of 60-70 years. Age was found to be a significant risk factor for CAD mortality among women, with increasing age correlating with a higher incidence of hypertension, diabetes, obesity, and dyslipidemia. The most common mode of presentation was chest pain, highlighting the importance of recognizing this symptom in the evaluation of CAD in females. Furthermore, systemic hypertension and diabetes mellitus were identified as additional risk factors for myocardial infarction (MI) in this population. In conclusion, this study underscores the need for early recognition and understanding of the various modes of presentation and clinical characteristics of CAD in females. Chest pain, along with systemic hypertension and diabetes mellitus, emerged as important factors to consider in the evaluation and management of CAD in this population.