This study describes the affective component of hostility as measured by the Cook-Medley Hostility Scale (Ho; W. Cook & D. Medley, 1954) by examining the relationship between facial expressions of emotion and Ho scores in 116 male coronary heart disease patients. Patients underwent the videotaped Type A Structured Interview, from which facial expressions were later coded using the Facial Action Coding System. They also completed the Cook-Medley Ho scale. Facial expression of the emotion of contempt was significantly related to Ho scores; anger expression was not. Also, there was a significant interaction between hostility and defensiveness, wherein low-defensive, highly hostile people showed substantially more contempt expression than others. The implications of these findings for the construct validity of Ho and for identifying clinically important subtypes of hostility are discussed.