Cardiovascular disease remains the most common cause of death worldwide, yet there is a wide variation in disease prevalence between different ethnic groups. One's individual risk is not entirely explained by 'traditional' risk factors and this, along with the observation that endogenous and lifestyle risk factors appear to cluster in the same individuals has led to the idea that there may be a common mechanism underlying this disease. It has been postulated that inflammatory pathways may be important. Results from our own and other studies have demonstrated that there may be ethnic differences in the level of circulating inflammatory markers which may be partially related to demographic, lifestyle or genetic factors. Before it is possible to add inflammatory markers to global risk scores it is imperative that a clear understanding of their function, normal range and major determinants in different ethnic groups is established. To date the ethnic research in this area has been very sparse and further work is urgently required. The usefulness of these inflammatory markers in the diagnosis and prognosis of disease in these different populations also needs to be investigated before therapeutic strategies can be fully developed.