Introduction: Ischemic Heart Diseases (IHD) are mostly attributed to increased exposure to traditional risk factors. Few studies were directed to understand the environmental and occupational determinants as potentially modifiable risk factors. Aim of work: To evaluate the impact of various working environments on the ischemic heart disease burden profile in young Egyptian male workers. Materials and Methods: Three years follow up of ischemic events in three groups of workers based on the type of industry was performed. Group I (Motor industry) which included 4779 individuals, group II (Construction industry) which included 6230 individuals & group III (Food industry) which included 2613 individuals. Main risk factors analysis were collected from out-patient visits and investigations results, followed by multicenter in time on site monitoring on groups records of in-patient admissions and different interventional coronary procedures performed. Results: Mean age in motor industry group was 34.6 ± 9, in construction group was 35.8 ± 9 while in food industry group was 31.6 ± 7. Total incidence of coronary artery disease in the three groups was 1.5%; of hypertension 4.3 %; of diabetes mellitus 3.5 % and that of dyslipidemia was 2.3 %. Incidence of coronary events in motor industry was significantly higher than the other two industries. Highly significant increase in number of total in-patient and critical care admissions due to acute coronary syndromes and myocardial infarction in addition to number of interventional coronary procedures was observed in motor and construction industries when compared to food industry. Conclusion: Different working environmental hazards might increase the incidence of coronary artery diseases in young Egyptian male workers either directly or through augmenting known risk factors. Morbidity due to IHD might be affected by the type of industry. Cooperation between general practitioners, occupational diseases specialists and cardiologists may improve the efficiency of prevention programs.