Aim To investigate the risk factors and clinical features of coronary lesions in patient with premature coronary heart disease. Methods 294 patients with coronary heart disease(CHD) were divided into premature CHD group(male<55 years old,n=104;female<65 years old,n=65) and aged CHD group(male≥55 years old,n=74;female≥65 years old,n=51).The risk factors of premature CHD and the features of coronary lesions were illustrated. Results The percentage of smoking,triglyceride(TG) level and family history in patients with premature CHD were higher than those in patients with aged CHD(P<0.05).But the patients with premature CHD had lower rate of hypertension and diabetes compared with the patients with aged CHD(P>0.05).There were significantly more premature CHD patients with acute coronary syndrome(66.3% vs 45.6%,P<0.05),more premature CHD patients had single vessel lesion(P<0.05),lower average lesion score(P<0.05). Conclusion Smoking,family history,increased TG level might play an important role in the development of premature coronary heart disease.