In recent years, mountain sports, especially ski mountaineering, are practised by increasing numbers. Although a high percentage of elderly with cardiovascular diseases is estimated, little is known about the real frequency of cardiovascular diseases among ski mountaineers. The goal of this study was to provide data on the frequency of cardiovascular diseases (coronary artery disease with and without myocardial infarction, hypertension, arrhythmias), collected among a representative sample of 937 ski mountaineers in the Austrian Alps. Data of 934 questionnaires were included into the evaluation. Regarding the whole sample, 5.8 % (95 % CI: 4.3 - 7.3 %) of the ski mountaineers are afflicted with at least one cardiovascular disease. The frequency of cardiovascular diseases is age dependent and more pronounced in men. Hypertension is the dominant cardiovascular disease in ski mountaineers. All persons with coronary artery disease with or without prior myocardial infarction and 79 % of the persons with cardiovascular diseases in general are males over the age of 40 years. Scientific research should provide the basis of an optimal risk management for this group of persons.