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Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Dioxins can cause cardiovascular toxicity in experimental animals. The potential role of dioxin exposure as a preventable risk factor has attracted the attention of public health services, especially because dioxin exposure is a ubiquitous problem. We aimed to investigate and clarify the effect on CVD risk of moderate-to-high exposure to dioxins. This cross-sectional study investigated 914 residents without CVD near a deserted pentachlorophenol factory. CVD-related factors were measured to examine their associations with serum dioxin. We also investigated associations between serum dioxins and the Framingham risk score. Serum PCDD/F levels were significantly positively associated with CVD risk in both genders (Men: b=0.023, P< 0.001; Women: b=0.005, P< 0.001; All: b=0.013, P<0.001). After adjusting for confounding factors, participants with higher serum PCDD/F levels had a higher risk for CVD than did the reference group (serum PCDD/levels <9.8 pg WHO98-TEQ(DF)/g lipid) (25th to <50th percentile, adjusted odds ratio (AOR)=2.96 [95% confidence interval (Cl)= 1.13-7.75]; 50th to < 75th percentile, AOR =3.37[1.32-8.59]; >= 75th percentile, AOR= 6.22 [2.47-15.63]). We hypothesize that accumulated dioxins heightens the cardiovascular risk. (C) 2011 Elsevier B.V. All rights reserved.