OBJECTIVES: To investigate the prevalence of cardiovascular risk factors among patients undergoing elective Coronary Artery Bypass Graft surgery (CABG) in Karachi, Pakistan. METHODS: Cardiothoracic surgery quality improvement is a core value of health care provision. In order to improve quality of care, information on key indicators needs to be systematically collected and maintained. In 2006, the cardiothoracic department at Aga Khan University developed an infrastructure that would enable us to answer the more challenging research queries in cardiac surgery practice. The resulting electronic cardiothoracic database is based on the Society of Thoracic Surgeons database. We chose the following aspects of patient care to be included in the database form: pre-surgery patient condition and medications, anesthesia information, perfusion information, surgery information, recovery information, status of the patient atdischarge,30-days and 365-days post-surgery follow-up information .Information was collected through structured questionnaire and entered into Microsoft Access  and analyzed in SPSS(Statistical package of social sciences). RESULTS: In this prospective study 2073 undergoing elective CABG were included. Mean age of the patients was 54.85±9.7 years, 14.7% of patients were females. Prevalence of risk factors among the study population, included: 47.10% were overweight, 14.7% were obese, 47.7% were diabetic, 69.50% were hypertensive, 50.20% were dyslipidemia, 47.7% were as smokers, 9.2% were in renal failure, addition, 53% of patients had family history of coronary artery disease, 46.7% had a history of myocardial Infarction (MI). The ,operative mortality rate was 0.3%.,Post surgery complications included renal failure in 14.8% of patients, arrhythmias in 7%, reoperation in 2.3%, prolonged ventilation in 3.1%. CONCLUSIONS: There is a high prevalence of risk factors like dyslipidemia, hypertension, diabetes and smoking for ischemic heart disease in our population.  Once we establish this fact we will work to control the risk factors and reduce the burden of disease so that’s why this study is being done