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Objectives: To find out if there is any relationship between serum level of albumin and ischemia modified albumin (IMA) estimated by albumin cobalt binding assay. The effectiveness of albumin adjusted IMA index in the diagnosis of Acute Myocardial Infarction (AMI) was also studied. Material and methods: We analyzed serum levels of IMA and albumin adjusted IMA index in 120 patients each with AMI and apparently healthy subjects belonging to the control group. Further, both control and AMI groups were separately divided based on serum albumin concentration in to four groups of <3.5g/dl, 3.51-4.0g/dl, 4.01-4.5 g/dl and>4.51g/dl (n =30 each). Sensitivity, specificity, positive predictive value and negative predictive value (NPV) of IMA was calculated and compared with that of Albumin adjusted IMA index. Results: There was a significant negative correlation (r =-0.473 and p value = <0.001) seen between the IMA level and serum albumin. Serum levels of IMA were significantly higher in AMI patients than in healthy controls (p value = <0.001), where as albumin adjusted IMA index values did not show any significant difference between the groups. Comparison of AMI and control groups showed higher values of Albumi