Objective To investigate the risk factors, clinical and angiographic features of women aged 50 or less with coronary artery disease(CAD). Methods One hundred and seventy-three female CAD patients comifrmed by coronary angiographic aged 50 or less were classiifed as group A, while another 494 non-CAD women aged 50 or less as group B. The differences in CAD risk factors, clinical and angiographic features between the 2 groups were analyzed. Results There were more women with diabetes, positive CAD family history, dyslipidemia or hypertension (especially diastolic hypertension) in group A than in group B. Patient in group A had higher diastolic pressures and serum glucose level than those in group B but both groups had similar body weights, systolic pressures and menopause ages. The serum total cholesterol and triglyceride levels were higher in patients in group A than those in group B while high-density-lipoprotein (HDL) cholesterol and apolipoprotein A levels were lower in group A. The low-density-lipoprotein (LDL) and apolipoprotein B were higher in group A than in group B but without signiifcance. There were more women with positive urine protein in group A than in group B. In group A, more than 50%of patients were with single diseased artery while another 15%with slight coronary artery atherosclerosis or even normal arteries. Most of the lesions were found in left anterior descending artery (LAD) and its branches. Conclusions Risk factors of CAD included diabetes, positive CAD family history, dyslipidemia, hypertension(especially diastolic hypertension) and positive urine protein in women aged 50 or less Menopause alone, without other CAD risk factors, would not lead to CAD. Single vessel disease was more commonly found in this group of patients.