Background: Health statistics show that cardiovascular disease are the one of 5 leading causes of mortality per 100,000 populations are and it has been increasing continuously (Health indicators 2014 of Mongolia). The Mongolian model list of essential medicine had published first time in 1991, since adoption of the treatment this model list, it has updated 7 times (1993, 1996, 2001, 2005, 2009, 2015). The comparable study between World Health Organization (WHO) model list of essential cardiovascular medicines and Mongolian model list of essential cardiovascular medicines not published yet. Good pharmaceutical management is an important approach to contain the increasing expenditures on medicines in developing countries. ABC and VEN analysis classify items according to their budgetary consumption and importance, respectively. When the two are combined together they increase efficiency in medicines supply chain systems and also diminish costs associated with overheads, wastages and inefficiencies. Few number of studies for pharmaco-economic analysis ABC/VEN in medicines have published in Mongolian (Guldana.Kh., 2011, Oyuntsetseg.G., 2012, Munkhtuya.B., 2012, Mamedova.S.E., 2010, Ziganshina.L.E., 2007, Alimenko.M.A 2010), but does not have any article of study pharmoco-economic analysis ABC/VEN of cardiovascular medicines in Mongolia. Aim of study: To study of cardiovascular medicines in second and tertiary hospital by pharmacoeconomic analysis ABC/VEN Materials and Methods: We have studied cardiovascular medicines list procured in Central Agency for Procurement of Mongolia (2014). Data were collected using pre-tested questionnaires and through document reviews. Analysis was performed by using Russian Pharmcompail 6.1.1 program, excel spreadsheet and SPSS version 17.0 computer software. Result: About 97 cardiovascular medicines were procured during the last financial year 2014 in 38 secondary level hospitals and tertiary hospitals. ABC analysis shows that, 19 (19.59%) medicines were found to be class A, while class B had 24 (24.74%) items whereas class C consisted of the remaining 54 (55.67%) medicine items and consumed 1.117.049.036 MNT (73.89%) in class A, 284.221.954 MNT (18.80%) in class B and 110.542.688 MNT (7.31%) in class C. Of the Heparin injection (5 000 IU) alone contributed 312.000.000 MNT (27.9%) of the class A. There was no special inventory control methods for class A items which are main drivers of medicine expenditures. ABC analysis provides an accurate and objective picture of budget expenditures on medicines. VEN-analysis helps to prioritize between various medicines in their selection for procurement and use within a drug supply system. We have found that 22 (22.68%) of the items included to Vital category, 62 (63.92%) to Essential category and 13 (13.40%) included to Non-essential category. The study showed Captopril 25mg, No-spa 40 mg, Cinnarizine 25mg, Cavinton 5mg, Validol 0.06gr, Adelphan 40 mg, Papaverine hydrochloride, Nimodipine 30mg, Dicynone 250 mg, Oxybral 30 mg, Captopril HCT, Phlebodia 600mg were not listed in Mongolian model list of essential medicines. About 13 medicines (90.812.055 MNT) were Non-essential and costing approximately 6.01% of the budget equivalent to 1.5 billion. It was interesting to find that more than half of the Vital, Essential and Non-essential medicines were lowest cost items belong. The hospital could have tried to minimize purchase of the Non-essential medicines and increase the amount of the Vital items since these are for life saving purpose. Conclusions 1. The ABC analysis notified that 20.65% of 1.117.049.036 MNT of the total budge in A class consumed to medicine affecting anti coagulation (Heparin 5 000 IU) injection accounting treatment of ischemic heart disease. The Streptokinase expenditure listed in Mongolian model list of Essential medicines was low (0.29%). 2. The study showed Captopril 25mg, No-spa 40 mg, Cinnarizine 25mg, Cavinton 5mg, Validol 0.06gr, Adelphan 40 mg, Papaverine hydrochloride, Nimodipine 30mg, Dicynone 250 mg, Oxybral 30 mg, Captopril HCT, Phlebodia 600mg were not listed in Mongolian model list of essential medicines. About 13 medicines (90.812.055 MNT) were Non-essential and costing approximately 6.01% of the budget equivalent to 1.5 billion. It showed that hospitals have possibility to change this portion of budget in to Essential category of medicines.