The presence of a diagonal ear lobe crease (DELC) was studied in 350 non-selected patients admitted to the Clinic. The overall incidence of DELC was 45%, with a significant increase after the age of 50 years (24.8% before and 59.5% after fifty, p less than 0.001). The relationship between DELC and ischemic chronic heart disease (65% as against 23% in the patients without DELC, p less than 0.001) and with some coronary risk factors: arterial hypertension (40% in patients with DELC, 29% in those without, p less than 0.01), smoking (43%) as against 35% in those without DELC. The relationship with diabetes mellitus and obesity was not significant. A higher incidence of DELC was observed in males (66%) than in females (34%) (p less than 0.02). The lipid profile of patients with DELC presents significant cholesterolemia changes (251 +/- 71 mg as against 232 +/- 70 mg in those without DELC) and a less marked increase in lipemia and beta-lipoproteins. All risk factors presented a net increase in the subjects with bilateral DELC. It is concluded that DELC can be used for selecting asymptomatic subjects in the screening of a possible coronary heart disease.