Background : We conducted a case-control study to examine the impact of coronal heart disease (CHD) risk factors on calcium oxalate (CaOX) stone formation. Methods : Variables included body mass index (BMI), current alcohol use, smoking habit, hypertension, hypercholesterolemia, diabetes mellitus, and hyperuricemia. Data sufficient for analysis were obtained for 181 CaOX stone formers and 187 controls.Results : Seven of 181 stone formers (3.9%) had a history of CHD compared with none of 187 control subjects ( P = 0.007). In univariate logistic regression analysis, smoking habit (OR 4.41, 95% CI 2.85-6.84, P < 0.0001), hypertension (OR 4.24, 95% CI 2.61-6.91, P < 0.0001), hypercholesterolemia (OR 3.03, 95% CI 1.77-5.20, P < 0.0001) and BMI (OR 1.10, 95% CI 1.04-1.17, P = 0.007) reached statistical significance. In a multivariate logistic regression analysis, smoking habit (OR 4.29, 95% CI 2.68-6.86, P < 0.0001), hypertension (OR 3.57, 95% CI 2.11-6.07, P < 0.0001), and hypercholesterolemia (OR 2.74, 95% CI 1.51-5.00, P = 0.001) reached statistical significance, while BMI (OR 1.06, 95% CI 0.99-1.12, P = 0.09) did not. Conclusions : CaOX stone formers are significantly associated with several CHD risk factors, including smoking habit, hypertension, hypercholesterolemia, and obesity.