OBJECTIVES: To calculate cost of illness due to coronary heart disease in the patients attending National Heart Center, Kathmandu, Nepal METHODS: Descriptive cross sectional survey was conducted. The total number of sample was 120. The sample was selected by non-probability purposive sampling method. Data entry and analysis was done using SPSS 16.0. Categorical variables were compared using Independent Sample t-test and cross tabulation was done and chi- square test was applied to show significant difference between variables. RESULTS:   Agriculture was the main source of income of the coronary heart disease household and the average annual household income was NRs. 1, 54,000 (US $ 1792). The study estimated the average cost of illness to be NRs. 30,888.14 (US $ 360) for an outpatient episode of coronary heart disease which was 20.05% of the average annual income of CHD household. The average total time loss of the CHD household was 8.75 person days. The average total direct cost was NRs. 29,600 (US $ 344) of which medical cost was the largest component. The average monetary value of time loss by the household was found to be 2,981.18 (US $ 35). CONCLUSIONS:   The study found high cost of illness due to centralised system of health care.The findings of the study showed that households struggled to cope and adopted unsustainable strategies that damaged asset and caused or sustained impoverishment. Thus, estimated cost appears to be sustained economic burden on the individual household.