Atherosclerosis is a complex and common disease contributing to increased mortality and morbidity. The exact global incidence of atherosclerosis is beyond calculation. Autopsy studies can provide information about the impact and course of atherosclerosis. Present study is undertaken to study the spectrum and distribution of atherosclerotic lesions in the coronary arteries and the association of age, sex, diet, socio-economic status, smoking and alcohol consuming habits with atherosclerosis. Methods : Heart specimens were obtained from medicolegal autopsies. Sections from representative areas were studied for gross and microscopic evidence of atherosclerosis. Results : Among the 50 cases studied 35 were males and 15 were females. Coronary arteries of 24 males (72.72%) and 9 females (27.27%) showed atherosclerosis. Males were affected more than females. Age has a dominant influence on atherosclerosis, it increased with age. 33 (66%) cases showed coronary atherosclerosis. Upper class, obesity, alcohol consumption and cigarette smoking trends have dominant role in acceleration of atherosclerotic lesions. Religion and vegetarianism have lesser affect on atherosclerosis. Among coronaries, left anterior descending artery is most commonly involved. Conclusion : Autopsy studies play a vital role in unraveling the spectrum and occurrence of atherosclerosis. Atherosclerosis is a complex and multifactorial disease. Smoking and alcoholism can accelerate the development of atherosclerosis. The incidence of atherosclerosis in developing countries (like India) is same as developed countries.