Introduction Prevalence of coronary artery disease (CAD) is on the rise in Sri Lanka resulting in high hospital mortality rates. Because of paucity of community based data on CAD we carried out this study to assess prevalence of CAD and associated factors in a suburban population in Southern Sri Lanka.Methods A cross sectional descriptive study was carried out among community living adults aged 30 years or more in Bope-Poddala Medical Officer of Health (MOH) area. Total of 1000 eligible individuals were recruited using cluster sampling. Cardiovascular Questionnaire of London School of Hygiene was administered to each participant by trained data collectors. CAD was diagnosed using criteria by Epstein and colleagues and electrocardiograms were classified according to the Minnesota code by a Cardiologist blinded to participant details [9,10].Results Total of 579 (57.9%) females and 421 (42.1%) males were studied. Mean age of the group was 53 years. Among the participants 32% had cardiovascular risk related non communicable diseases (NCDs) and 22.2% had a family history of the same. Prevalence of CAD was 6.9% (95% CI: 5.33 -0.47) and silent ischaemia was 2.2% (95% CI: 1.29 -3.11). Only gender and past history of cardiovascular risk related NCDs emerged as predictors of CAD.Conclusion CAD was more prevalent among males and those with past history of cardiovascular risk related NCDs. Community based preventive programmes should be implemented to minimize the adverse impact of CAD.