Background: We assessed racial differences in lipoprotein particle size, a marker of atherosclerosis risk, among women with coronary disease. Methods: We studied 378 women (33% non- White, predominantly African American) at the baseline visit of the Women's Angiographic Vitamin and Estrogen Trial (WAVE), a multi- center trial of hormone replacement and antioxidant vitamin therapy in postmenopausal women with established coronary artery disease. Average particle sizes for high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein were measured by nuclear magnetic resonance in these women, and angiography was performed at baseline and followup. Results: Adjusted for age, race, diabetes, smoking, blood pressure, and use of lipid- lowering and antihypertensive medications, non-White women had larger LDL particle size (difference.2 nm, 95% CI.1-.3 nm) and HDL particle size (difference.2 nm, 95% CI.1-.2 nm). Neither angiographic disease progression nor survival without myocardial infarction (median follow-up time of 2.8 years) was associated with lipoprotein particle size or race. Conclusions: Non-White women have a less atherogenic profile of lipoprotein particle sizes than do White women. However, this difference did not affect event-free survival or angiographic progression of coronary atherosclerosis.