Zinc deficiency is common among the elderly and has been associated with oxidative stress, immune dysfunction and CVD. We examined whether low zinc concentrations are associated with total, cardiovascular and non-cardiovascular mortality. Serum zinc concentrations were measured in 3316 patients from the Ludwigshafen Risk and Cardiovascular Health study, who were routinely referred to coronary angiography at a single tertiary care centre in Southwest Germany. After a median follow-up period of 7.75 years, 769 patients had died, including 484 deaths due to cardiovascular and 261 due to non-cardiovascular causes. After adjustments for cardiovascular risk factors and other possible confounders, the hazard ratios in the first when compared with the fourth zinc quartile, and per quartile decrease were 1.44 (95 % CI 1.13, 1.83; P = 0.001) and 1.15 (95 % CI 1.07, 1.24; P < 0.001) for total mortality, 2.20 (95 % CI 1.42, 3.42; P < 0.001) and 1.32 (95 % CI 1.16, 1.50; P < 0.001) for non-cardiovascular mortality and 1.24 (95 % CI 0.92, 1.66; P = 0.162) and 1.10 (95 % CI 1.01, 1.21; P = 0.038) for cardiovascular mortality. Furthermore, serum zinc concentrations correlated negatively with age and markers of inflammation and positively with antioxidants. The present results suggest that zinc deficiency may contribute to a reduced life expectancy in patients scheduled for coronary angiography.