Background: We elucidated whether trigeminal neuralgia (TN) patients are associated with an increased risk of developing coronary heart disease (CHD). Methods: Data retrieved from Taiwan Longitudinal Health Insurance Database (2000-2007) were analyzed. Patients with a primary diagnosis of TN and treated for TN at least once a month for 3 consecutive months following their initial diagnosis were identified as the TN subjects. Age- and gender-matched subjects without any diagnosis of TN were randomly selected at a ratio of 1:3 (TN vs. non-TN) and identified as the non-TN subjects. Study endpoint was the composite of CHD events, including acute myocardial infarction, percutaneous coronary intervention and coronary artery bypass grafting. Subjects younger than 20 years or older than 100 years or with a history of CHD events, multiple sclerosis, posterior fossa meningioma or neuroma or cancerrelated pain were excluded. Results: TN subjects (n=2937) had significantly higher incidences of diabetes mellitus, hypertension, hyperlipidemia, alcohol-related illnesses, obesity, smoking history, depression, and use of antidepressants, non-steroid anti-inflammatory drugs, opioids, and cardiovascular drugs (all P＜0.001) than non-TN subjects (n=8811). A propensity score was calculated using a logistic regression method and was then adjusted in the Cox proportional hazards regression model to balance the betweengroup differences in the distribution of observed baseline covariates. Our data revealed that the risk of developing CHD events in TN subjects was not significantly different from non-TN subjects (Hazard ratio= 0.86, 95% confidence intervals=0.68-1.10, P=0.224). Conclusions: Trigeminal neuralgia patients are not associated with an increased risk of developing CHD.