In order to document the prevalence of atherosclerosis of the major coronary arteries among Hong Kong Chinese, a study on material from autopsies done during the year 1981 in Queen Mary Hospital was carried out. The narrowest part of the proximal coronary arteries was studied by light microscopy and morphometrically by electronic digitizer. We found an onset of atherosclerosis in young adult males and a linear progression with age. Females had a delayed onset with a sharp rise after menopause. We were surprised to find an incidence of atherosclerosis among Hong Kong Chinese comparable with that in western populations, as distinct from Chinese in Mainland China. However, mortality due to ischemic heart disease remained relatively low. Racial factors may contribute to this partial dissociation between coronary atherosclerosis and ischemic heart disease.