Coronary heart disease (CHD) is not restricted to aged population anymore; when premature CHD develops in the younger individuals, it has distinct features and clinical presentation. The following describes a 21–year–old male who presented with stable angina and was found to have multi vessel coronary disease. Just at the age of 21, he got coronary artery bypass graft (CABG). The lab work done revealed the presence of mild dyslipidemia, high blood pressure, obesity, first hand smoking and a family history of lifestyle disorders were sufficient to induce ischemic heart disease at such an early age suggesting that “youth” can serve as protective factor only to a certain limit. INTRODUCTION CHD is presently the leading cause of death in the world with generally affecting the elder populations. However now a days it is emerging as a big threat in younger populations because of their lifestyle and presence of various risk factors. The Framingham study reported a 10–year incidence rate per 1000 myocardial infarctions of 12.9 in men of 30 to 34 years old and 5.2 in women of 35 to 44 years old.1 Review of a few studies, however, proved only approximately 4% of patients who had myocardial infarction (MI).1 Clinical and epidemiological studies have been conducted in identifying the risk factors and surgical outcomes in this group of patients.2,3 CHD risk factors differ in young population as in them it shows greater association with obesity, smoking and family history than hypertension and diabetes. In terms of clinical presentation, studies have revealed that younger patients with CHD more often present with acute coronary syndrome as opposed to stable angina.4,5 This is may be due to the fact that in young patients CHD is usually a single vessel disease as opposed to multivessel disease. The following case involves an unusual presentation of premature CHD in an uncommonly young individual.