Hyperhomocysteinaemia is considered as an important independent risk factor for atherosclerosis and thrombotic disease. This study determined the distribution of homocysteine (Hcy) levels in healthy Tunisian subjects and evaluated the relationship between Hcy levels and some cardiovascular risk factors. Randomly selected subjects (592 men and 114 women) were recruited from different regions of Tunisia. The overall mean Hcy level was 12.6 (SD 5.4) micromol/L. Hcy levels in subjects with hyperhomocysteinaemia varied according to geographical region. Subjects with hyperhomocysteinaemia had significantly elevated total cholesterol, LDL cholesterol, apolipoprotein A and apolipoprotein B and lower vitamin B12 levels compared with subjects with normohomocysteinaemia. Hcy levels correlated with total cholesterol (r = 0.09), apolipoprotein A (r = 0.012), and B (r= 0.013) levels and total/HDL cholesterol ratio (r = -0.085). Further epidemiological studies are needed to determine the precise role of Hcy in cardiovascular disease.