The study examines the relationship between fruit and vegetable intake (g/d) and CVD risk factors in urban south Indians. The study population comprised of 983 individuals aged > or = 20 years selected from the Chennai Urban Rural Epidemiological Study (CURES), a population-based cross-sectional study on a representative population of Chennai in southern India. Fruit and vegetable intake (g/d) was measured using a validated semi-quantitative FFQ. Linear regression analysis revealed that after adjusting for potential confounders such as age, sex, smoking, alcohol, BMI and total energy intake, the highest quartile of fruit and vegetable intake (g/d) showed a significant inverse association with systolic blood pressure (beta = - 2.6 (95 % CI - 5.92, - 1.02) mmHg; P = 0.027), BMI (beta = - 2.3 (95 % CI - 2.96, - 1.57) kg/m2; P < 0.0001), waist circumference (beta = - 2.6 (95 % CI - 3.69, - 1.46) cm; P < 0.0001), total cholesterol (beta = - 50 (95 % CI - 113.9, - 13.6) mg/l; P = 0.017) and LDL-cholesterol concentration (beta = - 55 (95 % CI - 110.8, - 11.1) mg/l; P = 0.039) when compared with the lowest quartile. A higher intake of fruit and vegetables explained 48 % of the protective effect against CVD risk factors. Increased intake of fruits and vegetables could play a protective role against CVD in Asian Indians who have high rates of premature coronary artery disease.