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Objective: To observe frequency and possible association of tooth loss with prevalent coronary heart disease in Pakistani population. Methodology: Angiographically determined coronary heart disease (CHD) patients of Punjab Institute of Cardiology, Lahore, Pakistan, and healthy individuals were enrolled for status of tooth loss. Results: Nine hundred and thirty six CHD patients and 595 healthy subjects with mean age of 51.9 ± 8.4 years were examined. Mean (±SD) tooth loss was significantly (P ⩽ 0.001) higher in cardiac patients (9.8 ± 9.2) than healthy subjects (6.8 ± 6.9) with odds ratio (OR) = 1.543 (95%CI = 1.985–2.851). Tooth loss was significantly (P ⩽ 0.001) associated with CHD males and females and cardiac patients with diabetes and smoking. After adjustment of age, gender, diabetes and smoking, subjects with CHD were more likely to have higher tooth loss. Conclusion: Tooth loss was significantly associated with prevalent CHD independent of classic risk factors of age, gender, smoking and diabetes in this study sample.