This review summarizes the effect of a habitual vegetarian diet on clinical complications in relation to chemistry and biochemistry. Omnivores have a significantly higher cluster of cardiovascular risk factors compared with vegetarians, including increased body mass index, waist to hip ratio, blood pressure, plasma total cholesterol (TC), triacylglycerol and LDL-C levels, serum lipoprotein(a) concentration, plasma factor VII activity, ratios of TC/HDL-C, LDL-C/HDL-C and TAG/HDL-C, and serum ferritin levels. Compared with omnivores, vegetarians, especially vegans, have lower serum vitamin B₁₂ concentration and n-3 polyunsaturated fatty acid (PUFA) levels in the tissue membrane phospholipids, which are associated with increased collagen and ADP stimulated ex vivo whole blood platelet aggregation, plasma 11-dehydrothromboxane B₂, and homocysteine levels and decreased plasma HDL-C. This may be associated with an increased thrombotic and atherosclerotic risk. It is suggested that vegetarians, especially vegans, should increase their dietary n-3 PUFA and vitamin B₁₂ intakes.