Aim To investigate the relationship between tumor necrosis factor-β gene polymorphism as well as its serum levels and coronary heart disease. Methods Nested polymerase chain reaction (PCR) coupled with allele-specific PCR (AS-PCR) were used for the detection of tumor necrosis factor-β genotype in 290 elderly patients with coronary heart disease and 239 elderly healthy controls. The serum tumor necrosis factor-β levels were measured by ELISA. Results Three genotypes CC, CA, AA were detected in both groups, and the genotypes were 25.9% and 37.2%, 49.3% and 45.6%, 24.8% and 17.2%, patients and controls respectively. There were statistically significant differences in the distributions of the genotypes (p<0.05) and the allele frequencies (p<0.05) between two groups. The relative risk suffered from coronary heart disease of AA and CA genotypes was 1.701 times of the CC genotype (Or=1.701, 95%CI: 1.173～2.466). The serum tumor necrosis factor-β levels of the patients were significantly different from that of the controls (p<0.05), however, among different tumor necrosis factor-β genotypes (CC, CA, AA) of patients and controls respectively, there were no significantly differences. Conclusions The single nucleotide polymorphism (SNP) at position 804 in the exon 3 of tumor necrosis factor-β gene is associated with coronary heart disease and the allele A may be a risk factor for coronary heart disease in Chinese. tumor necrosis factor-β gene polymorphism may affect coronary heart disease through its serum levels.