Background: Coronary Heart Disease is a big concern for the health of the residents of India. Environmental contaminants, air pollutants, synthetic chemicals, and the mineral content in drinking water can affect the heart by altering the heart rate, contractility and excitability of heart muscle or by causing atherosclerosis. Objective: The aim of this study is to observe the level of arsenic exposure and clastogenic effect of arsenic in coronary heart disease cases of West Bengal. Methods: A total 511 cases were screened. Our study group included 100 nos of coronary heart disease cases and 70 no of healthy controls from West Bengal. Multivariate Logistic Regression and Student’s t - test was used for statistical analysis of the parameters. The clastogenic effect of Arsenic was also examined by performing Cytogenetic Analysis. Results: Multivariate logistic regression analysis has revealed that a patient’s age, Low density lipoprotein level and hypertension played a significant role in the development of CHD. Hair arsenic level in CHD cases (0.7±0.2) μg/kg was significantly high (p<0.01) than that of the controls (0.20±0.09) μg/kg. Mitotic index (4.4±0.21) was significantly low (p≤0. 05) and chromosomal aberration (0.61±0.13) was significantly higher (p≤0. 005) in CHD cases. Conclusion: This study has revealed the facts that age, low density lipoprotein level, hypertension are the three significant risk factors of CHD. It was found that, the hair arsenic content of the CHD cases in this region was having the arsenic body burden. Clastogenic effect of arsenic on coronary heart disease cases.