Abstract: AIM:To analyze the relationship between cardiovascular risk factors and the severity of coronary artery disease (CHD) and to evaluate the relevance of risk factors and CHD and gender differences. METHODS: A total of 1 786 patients (1 214 males and 572 females) who underwent coronary angiography were selected, and their gender, ages, blood pressure, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), uric acid (UA), blood sugar and smoking history were recorded and calculated by the Gensini score. All cases were divided into four groups according to Gensini score. Risk factors were compared among the various groups, and the relationship of CHD and risk factors was first analyzed generally and then analyzed by gender with logistic regression. RESULTS: Univariate analysis of CHD risk factors and relevance of coronary lesions showed that Gensini score increased with the increase of age, TC and LDL, whereas HDL decreased. No significance difference was found in TC and UA between groups. Gensini score also increased in males, smokers, and patients with hypertension and diabetes. Logistic regression analysis showed that the most significant risk factors for CHD were diabetes followed by smoking, low HDL, high LDL, aging and gender, but no significant difference was found in hypertension (P=0.10) and high TG (P=0.29). Analysis by gender showed that smoking was the most significant risk factors for males followed by low HDL, high LDL, diabetes and aging. Diabetes was the most significant risk factor for females followed by low HDL. Aging and smoking were not significant factors for females. CONCLUSION: Increasing age, TC, LDL, HDL, hypertension, diabetes and smoking are risk factors shown to increase the severity of CHD, among which diabetes is one of the most significant CHD risk factors, particularly for females.