Coronary artery disease (CAD) is an important cause of morbidity and mortality in most industrialized nations, and is gaining in importance as a major disease in developing countries as well. Several risk factors, such as cholesterol, smoking, hypertension, obesity, diabetes, stress and physical activity, have been identified as contributors to the pathogenesis of this disease. Studies done in many countries on South Asian immigrants clearly demonstrate the increased risk for coronary heart disease in this population compared to that of local ethnic groups. Higher prevalence of diabetes, blood pressure, glucose intolerance, insulin resistance, low levels of HDL-cholesterol, high levels of LDL-cholesterol, increased plasma triglycerides and obesity are some of the risk factors identified as contributing to CAD in South Asians. The present report will review briefly the available data on CAD and its pathogenesis with particular emphasis on the problems unique to South Asians.