Background Toll like receptor 4 (TLR4), a member of the pathogen recognition receptors (PRR), has been shown to be implicated in atherosclerotic pathogenesis.But its precise mechanism remains unclear.The aim of the present study was to examine whether common variants of TLR4 are associated with coronary atherosclerotic heart disease (CAHD) in Chinese individuals.Methods A total of 400 unrelated patients with CAHD and 400 age and gender matched unrelated Chinese subjects were recruited in our study.Two tagSNPs in TLR4, rs1927911 and rs2149356, were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.An association analysis was then performed for each SNP.The relation to clinical characteristics was also examined in CAHD subjects.Results No significant differences in genotype and allele frequencies for rs1927911 and rs2149256 were noted between cases and controls.Howev/er, when stratified by age, a significant difference in allele and genotype frequencies of rs2149356 between CAHD and controls was observed in the group whose age are under 60, but not in the other group.Conclusions Our study revealed an age-specific effect of rs2149356 in Chinese CAHD subjects.TT homozygote affects CAHD sus ceptibility in subjects under 60.No association between rs1927911 and CAHD was found.Further studies and larger patient cohorts are required to exclude TLR4 from candidate genes of coronary atherosclerotic heart disease in the Chinese Han population.