Objective:To investigate the relationship between the coronary heart disease and the microsomal triglyceride transfer protein(MTP)-493G/T gene polymorphism. Methods:There was a case-control study,which enrolled 335 non-diabetic patients with coronary heart disease(CHD) and 206 control subjects without CHD. The genotype and allele frequencies of MTP-493G/T gene polymorphism were detected by polymerase chain reaction-restricted fragments length polymorphism(PCR-RFLP). Results:The highest frequency of MTP-493G/T genetic variation was GG genotype; the second was GT genotype; and the lowest was TT genotype in Han population of Jiangsu Province,China. Both the TT genotype frequency(6%) and the “T” allele frequency(19%) in the patients with CHD were higher than those in the control(3% and 12%), respectively(P < 0.05). But there wasn’t a significant correlation between MTP-493G/T genotypes and the number of significantly diseased vessels. The TT genotype had the higher TG and LDL-C level(P < 0.05) than GG genotype. In multiple Logistic regression analysis,the TT genotype odds ratio for coronary heart disease was 2.14(95%CI 1.22~6.56,P = 0.014). Conclusion:The TT genotype of MTP-493G/T genetic variation might increase the risk of coronary heart disease, independent of lipid and lipoprotein factors.