The prevalence of premature “Coronary Artery Disease (CAD)” is on the rise globally, and India is no exception. The present study aimed to assess the risk factors associated with “Premature Coronary Artery Disease (PCAD)” in patients from western India, using a hospital-based analytical cross-sectional design. Material and methods: This hospital-based analytical cross-sectional study included 252 subjects, of which 100 were in the PCAD group and 152 were in the CAD group with age over 45 years. The study participants were assessed for various parameters, including age, gender, hypertension, diabetes, dyslipidemia, central obesity, family history of CAD, smoker, tobacco chewer, periodontitis, angiographic severity based on “Single vessel disease SYD”, and “double vessel disease (DVD)” and “triple vessel disease (TVD)”. Results: The results showed that a significant proportion of patients had a family history of PCAD (63.6%) and hypertension (53.2%). Other important risk factors included smoking (48.8%), dyslipidemia (44.8%), and diabetes (37.6%). Interestingly, there was a higher prevalence of PCAD in males (72.4%) compared to females (27.6%).