OBJECTIVES: Generalized CE analysis (GCE) is a methodology designed by WHO to inform decision makers about coverage of interventions based on allocative efficiency. There is strong evidence that 50% of the reduction of the cardiovascular (CV) deaths is attributable to reduction of smoking, hypertension and hypercholesterolemia. We aimed to use GCE to identify the best mix of interventions to diminish CVD from the perspective of the Health Secretariat of Buenos Aires. METHODS: Six personal (treatment of patients with hypertension, hypercholesterolemia, smoking and integrated clinical strategies to reduce the 10 year CV Risk) and non personal (negotiation with bakers about sodium reduction and mass education strategies to reduce hypertension, hypercholesterolemia and obesity) interventions were selected. Effectiveness was based on Systematic Reviews and Meta-analysis entered into stochastic age and sex specific models to predict their impact in DALY's saved. To translate the age and sex adjusted incidence of CV events into health changes, WHO (PoPMod) was used. Costs were measured in Argentine pesos and international dollars adjusted by PPP. CER were discounted at an annual rate of 3%. RESULTS: The reduction in the sodium content and the intervention on subjects with more than 20% CV risk were the two most cost-effective strategies (A$ 401 and A$899 per DALY averted respectively). The other best ranked strategies were: Mass media campaign (A$1.464), combined therapy 10% and 5% CV risk (A$ 4.530 and A$ 4.870) and then hypertensive therapy, hypercholesterolemia therapy and smoking cessation (A$ 10.523, A$ 42.939 and A$ 79.872) in that order. CONCLUSION: The population based and the combined therapy targeted to those with more than 20% CV risk were the more cost-effective interventions with less than A$ 1.000 per DALY averted. It is desirable that the diffusion of this methodology in developing countries make resource-allocation decisions less empirical and more driven by allocative efficiency evidence.