The differences of the clinical characteristics, risk factors, treatment and prognosis in coronary heart disease (CHD) patients from different races, area and countries are rarely reported. Collecting, comparing and analyzing the clinical data and blood examination results of 650 Chinese Han and 640 German Caucasian patients with CHD. The ratio of the first hospitalization because of CHD in Chinese patients was higher than that in Germans (95.1 vs. 38.1% P < 0.01). CHD occurred most frequently in elder men of both nations. The German CHD patients combined with hypertension, dyslipidemia and abnormal glucose metabolism were clearly more often than Chinese patients. Other risk factors such as fibrinogen, homocysteine and the proportion of positive family history of premature CHD, obesity, hyperuricemia were higher in German patients than that in Chinese patients. However, the ratio of smoking, acute myocardial infarction and the levels of high-sensitivity C-reactive protein in Chinese patients were obviously higher than that in Germans (P < 0.01, P < 0.05). The use of aspirin in both groups was the same, but the use of statins, beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers were distinctly lower in Chinese patients compared to Germans (P < 0.01, P < 0.05). The proportion of percutaneous coronary intervention and coronary artery bypass grafting in Chinese patients was lower than that in Germans (P < 0.01). The usage of drug-eluting stents to bare-metal stents was slightly higher in German patients, whereas it was obviously higher in Chinese patients (P < 0.01). There were significant differences in clinical characteristics, risk factors and treatment of Chinese Han and German Caucasian patients with CHD.