Premature coronary heart disease(pCHD)is a special type of cardiovascular disease. Recent research has demonstrated that pCHD possesses a strong genetic basis, genetic factors account for almost 50%~60% morbidity rate of pCHD, and lipid metabolism gene plays the most important role in it. Genetic variations of lipid metabolism can lead to the impediment of lipid synthesis and catabolism, as well as a series of disease characterized by atherosclerosis(As)and pCHD.This review aims to give a brief summary of the relationship between the genetic variations of lipid metabolism and pCHD.