Objective An association between coronary artery disease (CAD) and serum omentin-1 was recently identified. The aim of the present study was to investigate the effect of atorvastatin on serum levels of omentin-1 in patients with CAD. Methods One-hundred and ninety-eight patients with CAD were divided into two groups: those with acute coronary syndrome (ACS) and those with stable angina pectoris (SAP). All patients were randomized to receive atorvastatin therapy at a dose of either 20 or 40 mg/day for 12 weeks. Serum omentin-1 levels and other parameters were determined at baseline and at the end of the study. Results Atorvastatin at 20 and 40 mg/day increased serum omentin-1 levels in patients with ACS (20 mg, P = 0.007; 40 mg, P < 0.001) and in those with SAP (20 mg, P = 0.017; 40 mg, P < 0.001). Atorvastatin at 40 mg induced greater changes in serum omentin-1 levels compared with 20 mg atorvastatin in both the ACS group (P = 0.003) and the SAP group (P = 0.012). The increments of serum omentin-1 levels with atorvastatin administration inversely correlated with changes in LDL cholesterol (r = -0.145, P = 0.041), interleukin-6 (r = -0.162, P = 0.023), and high-sensitivity C-reactive protein (r = -0.185, P = 0.009) in patients with CAD. Furthermore, changes in LDL cholesterol (beta = -0.158, P = 0.027) and interleukin-6 (beta = -0.154, P = 0.044) remained independent determinants of omentin-1 alterations in standard multiple regression analysis (R-2 = 0.122, P = 0.006) after adjusting for age, sex, smoking, family history of CAD, and BMI in patients with CAD. Conclusion Atorvastatin increased serum omentin-1 concentrations in patients with CAD in a dose-dependent manner. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.