Although several risk factors have been identified for ischaemic heart disease, yet their predictive value on an individual basis remains rather low. Hence there is a need to identify other variables that can be associated with ischaemic heart disease. Fibrinogen level has been associated as an independent risk factor in studies undertaken in the west. This study was done to find out whether fibrinogen level is a risk factor in Indian populations. Out of 131 consecutive male subjects undergoing coronary angiogram over a four-month period, 98 were found to have ischaemic heart disease based on angiogram. Fibrinogen levels (estimated using the Clauss method) were higher in patients with ischaemic heart disease when compared with controls (374 +/- 11.9 vs 268 +/- 14.9 p < 0.0001). In the multivariate analysis it was found that fibrinogen levels more than 300 mg percent had an odds ratio of 4.4 for ischaemic heart disease (confidence interval of 2.4 to 19). The only other variable associated with ischaemic heart disease other than fibrinogen, was low level of HDL. The fibrinogen levels were higher in patients with triple-vessel disease when compared with single or two-vessel disease. Our results are in agreement with the findings in the west that fibrinogen levels are a risk factor for ischaemic heart disease. This factor needs to be addressed seriously and steps taken to lower the fibrinogen level in clinical practice.