A 59-year-old man with long-standing hypertension presented with exertional chest pain. An electrocardiogram and cardiac stress testing were unremarkable. Coronary angiography, however, revealed substantial stenosis, and two stents were placed. The patient’s recovery was uneventful, and he has returned to the clinic with no further chest pain. The patient was noted to have bilateral Frank’s sign, which is a diagonal crease in the earlobe that runs backward from the tragus at a 45-degree angle across the lobule to the rear edge of the auricle and may be a predictor of coronary artery disease. Frank’s sign is thought to indicate premature aging and loss of dermal and vascular elastic fibers. Although it has limited sensitivity, the sign is more useful diagnostically in persons younger than 60 years of age than in older persons.