The coronary risk factor status of women before and after coronary artery bypass grafting has not been fully described. This study was a prospective investigation of 136 women who underwent first-time, isolated coronary artery bypass grafting between February 1992 and October 1993. Major coronary risk factors were measured at the time of surgery and again 6 months later. The sample was 22% black, had a mean age of 64 years, and an average of 11 years of education. Substantial favorable changes in risk factor status occurred in the prevalence of smoking and the number of cigarettes smoked per day among smokers. Although the self-reported dietary intake of fat decreased significantly, the dietary consumption of fat, saturated fat, and cholesterol remained above the recommended levels of the Step II diet and weights remained essentially the same. Mean systolic and diastolic blood pressures significantly increased and a substantial number of patients (59%) continued to exhibit hypertension at 6 months. No significant changes in plasma lipid concentrations were achieved. At 6 months, one third of the women exceeded recommended levels for triglycerides, 85% for total cholesterol, and 92% for low-density lipoproteins. In addition, 34% had high-density lipoprotein levels < 40 mg/dl. Health care professionals need to target these women for effective secondary prevention.