Background: Coronary heart disease (CHD) has remained the primary cause of mortality globally. Contrary to the long-held belief that CHD is primarily a male health concern, recent research has revealed that women are also at significant risk, especially following menopause when hormonal fluctuations can contribute to increased cardiovascular risk. Aim: The present study aimed to determine the demography of coronary heart disease (CHD) in women in Kuala Lumpur, Malaysia. Method: This retrospective cross-sectional study involved 158 autopsy cases of women with CHD received at the Forensic Unit, Universiti Kebangsaan Malaysia, between the years 2000 and 2019. They were between 20 and 90 years old and analyzed in different age groups, including risk factors, clinical presentations, and types of coronary artery occlusions. Results: Coronary heart disease was found to be the highest between 50 and 59 years old (34%). Most women had several risk factors for CHD (80%), such as obesity (51%), hypertension (23%) and diabetes mellitus (19%). They were predominantly asymptomatic before death (56%). For those with symptoms, they were more chest-related (65%), with single-vessel occlusion being the commonest pattern (42%). This study concluded that fatal CHD cases in women in urban areas showed alarming issues. Despite the disease's risk factors, most of them were asymptomatic. Hence, the detection of CHD in women is warranted to provide careful planning of healthcare services for early screening and treatment purposes.