Interleukin-10 (IL-10) is an anti inflammatory cytokine involved in the ongoing coronary inflammation and related patho-physiological processes. The piece of work presented herein is aimed at investigating possible association of polymorphisms in IL-10 promoter with Saudi cardiovascular disease (CVD) patients. The study included 80 confirmed CVD patients with diabetes and 75 healthy control individuals both men and women. Concentration of IL-10 in the serum samples were measured by ELISA method. For single nucleotide polymorphism (SNP) analysis, Sanger method of DNA sequencing was followed. The IL-10 level was found to be significantly elevated in CVD patients (P < 0.001) and its associated complications viz. ST-elevation myocardial infarction [STEMI] (P <0.01), non ST-elevation myocardial infarction [NSTEMI] (P < 0.05), and unstable angina [UA] (P < 0.001). We also observed a significant association between polymorphisms in IL-10 promoter at -1082 and -819 locus with Saudi CVD patients. Moreover, at -1082 A/G locus, AA haplotype was found to be less frequent in the CVD patients compared with control individuals. On the other hand, highly significant rise in heterozygous (A/G genotype) condition was observed in patient samples compared with control ones (P < 0.001). Similarly, the genotypic frequencies at -819 C/T locus were also found to be significantly associated (P < 0.001) with CVD patients compared with control individuals. Our study provides the status of polymorphism in IL-10 promoter and its association with CVD risk in Saudi population. As per our information, ours is the first article that shows the genetic diversity in IL-10 promoters and its level in the Saudi CVD patients. © 2017 IUBMB Life, 69(7):522-527, 2017.