To examine the roles of sex hormones and oxygen free radical(OFR) in coronary heart disease (CHD), the serum estradiol(E2), testosterone(T), SOD, MDA and lipid levels were measured in 44 postmenopausal women with CHD and 22 health women. Mean levels of T and MDA were significantly higher while mean levels of SOD and E2 were significantly lower in CHD group than those in control group. On relative analysis, there was a positive correlation between E2 and SOD, while a negative correlation was observed between T and MDA in CHD group. Eighteen postmenopausal women with CHD had been receiving nilestriol replacement therapy for 12 weeks. The serum SOD and HDL-C/TC levels increased significantly, but LDL-C and MDA decreased significantly. The overall data suggest that OFR plays an important role in CHD; Low E2 levels is a risk factor of CHD in postmenopausal women; Nilestriol replacement therapy can improve the metabolism of serum lipids and inhibit lipid peroxidation, therefore, it may be of benefit to postmenopausal women with CHD.