Abstract: The conventional risk factors associated with coronary heart disease (CHD) include hypertension, diabetes mellitus, dyslipidemia and hypercholesterolemia, obesity and overweight, smoking and alcohol consumption, etc.. The incidence of CHD has increased year by year, and a discernible shift towards a younger age of onset is evident. "The third report of the national cholesterol education program adult treatment panel Ⅲ" (NCEP ATP-Ⅲ) defines premature CHD (PCHD) as manifestation in males < 55 years and females < 65 years. At recently, PCHD has emerged as a focal point in both domestic and international study. In addition to the established risk factors, there is a important need to elucidate novel pathogenic mechanisms and predictive factors governing PCHD. This necessitates concerted efforts in primary prevention. This manuscript conducts a comprehensive review of antecedent researches, with the primary objective of discussing the latest pathogenic mechanisms and predictive factors associated with PCHD. The reviewing aim is to contribute substantive insights to the primary prevention of PCHD.