Abstract: AIM: To compare the risk factors and the coronary artery lesions between young and elderly patients with coronary heart disease. METHODS: One hundred thirty two elderly patients and 81 young patients were identified as coronary heart disease by coronary angiography. The risk factors, coronary artery lesions and the results of stents were analyzed. RESULTS: 1) Smoking, hyperlipdemia and hypertension were the top three risk factors. The percentage of overweight in young patients was significantly higher than in elderly patients (38% vs.12%)(P<0.05). 2) The percentage of patients with more than two lesions in young patients was significantly lower than in elderly patients (53% vs.72%)(P<0.05) and was 74% and 94% in overweigh patients, respectively. Left descending artery (LAD) lesions were 48% and 41%, respectively. 3) The percentage of stent-planting in elderly patients was significantly higher than in young patients (85.9% vs.56.8%)(P<0.01). 4) The percentage of hospitalization from the emergency department was significantly higher in young patients (37% vs.12%)(P<0.05). CONCLUSION: Smoking, hyperlipdemia and hypertension are the top three risk factors for coronary heart diseases. Overweight and hypertension are also important factors in young patients. The lesions are serious in elderly patients with a long history of smoking and alcohol consumption. Elderly patients suffer from more serious lesions, and the lesions in about half of them involve LAD. Young patients tend to have an abrupt onset of coronary heart disease.