Coronary heart disease (CHD) is the leading cause of death among adults in developed countries. It is noted that with age the fat deposits in the wall of the coronary arteries as well as the other blood vessels supplying the heart. As a result of this deposition, there is a decrease in the blood supply to the heart causing angina and shortness of breath and may also result in a fatal myocardial infarction. There are several modifiable risk factors for CHD and one of them being the increased level of the amino acid i.e homocysteine (HCY) which when treated can reduce the risk of CHD. The positive correlation between hyper homocysteinemia and cardio vascular disease (CVD) has established firmly with the data derived from experimental and epidemiological observations. Clinical data authenticate that HCY is an independent risk factor for CVD. The current article is aiming to evaluate potential role of HCY on CVD risk at molecular level, and deep insights into a pathophysiology of CVD and their associations with CVD.