Objectives: This study was carried out to investigate the relationship of coping styles and stress with Coronary Heart Disease (CHD), as well as evaluating inefficient coping styles in patients with this disease. Method:  In a case-control study, 80 patients with coronary heart disease (40 males, 40 females) who had presented to Shahid Madani Hospital in the city of Tabriz were compared with 80 controls (40 males, 40 females) who were selected using convenience sampling, and were matched by a number of demographic factors with each other. Data were gathered using Coping Style Questionnaire (CSQ) and Holms-Rahe Life Stress Inventory, and were analyzed via Logistic Regression, Multiple Analysis of Variance (MANOVA) and t-test. Results: CHD patients have higher stress rates in comparison with controls, and use emotion oriented coping styles in general. Seventy nine percent of the variance related to the development of CHD is due to stress and coping styles, among which emotion oriented coping style had the highest (51%) and stress had the lowest (11%) share. Male CHD patients mostly used the inefficient direct confrontation style and female CHD patients mostly used the inefficient self-control style. Conclusion: There is a significant relationship between emotion oriented coping styles and CHD, and gender has an important role in this regard.