Coronary artery disease (CAD) is a significant health problem worldwide. The prolonged low-grade inflammatory activation in obese patients is believed to aggravate hemostasis disruption, resulting in premature mortality. The trace elements’ involvement in excessive adipose tissue metabolism is postulated. Among trace elements, manganese (Mn) is an essential trace element involved in numerous biological processes, including inflammation regulation, mitochondrial function, metabolic enzyme activity, and antioxidant defense. This study aimed to assess the concentration of trace elements, especially manganese, in the hair of patients with chronic coronary syndrome and to explore its relationship with obesity and coronary disease.  Hair samples were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). Patients were divided into groups based on the presence of coronary artery disease and body mass index (BMI). The results showed significantly higher manganese levels in the hair of obese patients, regardless of coronary disease status. This suggests that increased manganese concentration may reflect metabolic disturbances linked to obesity rather than being directly related to coronary disease. Higher manganese levels might be connected to increased oxidative stress and metabolic demands in obese individuals. A limitation of the study is the small number of participants, which requires confirmation in larger populations. In conclusion, manganese levels in hair may serve as a marker of metabolic changes related to obesity but do not directly correlate with coronary artery disease risk. These findings highlight the need for further research on manganese’s role in metabolic regulation.