Abstract: AIM To investigate the difference of the risk factors and coronary lesion characteristics in female and male patients with heart disease. METHODS Seventy-three female and 172 male patients, who had been diagnosed CHD by positive coronary angiography from Jan. 2003 to Dec. 2005, were included in the study. Their numbers of branches, extent and Gensini cumulative index of coronary lesions, clinic characteristics and risk factors, the levels of cardiac troponin T, C reactive protein and fibrinogen were comparatively analyzed. Cardiovascular risk factors included age, gender, history of family, hypertension, smoking, type 2 diabetes mellitus and dyslipidemia. RESULTS Compared with those in male group, the female group had older age, longer abdomen circumference, less typical angina and fewer numbers of risk factors, higher the levels of blood cholesterol, high-density lipoprotein, fasting serum glucose and rate of ECG abnormality, but lower triglyceride. No significant difference was seen in the levels of cardiac troponin T, C reactive protein and fibrinogen between female group and male group. The female group had fewer the branches of coronary lesion and lower Gensini cumulative index of coronary lesions. CONCLUSION Female coronary heart disease patients tend to have atypical angina but the detectable ECG rate is higher. Compared with their male counterparts, female coronary heart disease patients have fewer risk factors and less severe abnormality.