Introduction: Coronary artery disease has become one of the major causes of death in the recent years in developing countries like India. The coronary dominance pattern varies in different regions & populations. Our aim is to determine the coronary dominance using low cost silicon casts among the south Indian population & to determine its clinical significance. Methodology: In the present study 110 adult human cadaveric hearts (90 males & 20 females) were utilized & silicon material was injected into each coronary artery & cast was removed. The origin of posterior inter–ventricular artery was taken as the criteria for determining the dominance pattern. Result: Out of 110 hearts, 92 (83.63%) had right dominance, 12 (10.90%) had left dominance & only 6 (5.45%) had co–dominant patterns. Conclusion: Knowledge of coronary dominance will help the cardiologist & cardiac surgeons to evaluate and plan treatment of patients with unstable angina & myocardial infarction among the south Indian population. This is a new innovative technique wherein silicon is being used to study the vascular pattern, silicon was found to have more advantages than resins. Silicon casts can be utilized to study various vascular patterns of different viscera in intricate details by the future researchers & academicians in future.