Background: Variant angina is associated with endothelial dysfunction of the coronary artery in some reports. On the other hand, serum uric acid are correlated with endothelial dysfunction. Thus, we investigated whether uric acid are correlated with VSA. Methods: This study is a retrospective analysis of patients (n=1086) who underwent a coronary angiogram with ergonovine provocation (ERG test) from January 2008 to May 2013. We divided them into a spasm group (n=426), who showed coronary spasm by the ERG test, and an non-spasm group (n=660), who showed negative ERG test. We compared serum markers between the two groups, including low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and uric acid. Results: The mean age and sex of the study populations was 53.5±10.8 years and female 52.6% in spasm group, and 54.5±10.9 years and female 52.3% in non-spasm group. Uric acid was significantly higher in the spasm group than in the non-spasm group (p<0.05) while there were no significant differences in the other parameters. Uric acid is associated with HDL cholesterol (p=0.036) and triglyceride (p=0.016) in spasm group. Conclusions: Serum uric acid is associated with coronary artery spasm, and medical intervention to decrease uric acid might be effective in controlling coronary artery spasm.