Objective: To investigate whether being an immigrant is increase risk for AMI and stroke. Design and setting: A retrospective analysis of Victorian hospital admissions in 1996/97 and 2001/02 was conducted. Participants: AMI and stroke were defined using primary cases of admission of ICD-9-CM:‘P410’,ICD-10-AM:‘121’,‘122’and stroke ICD-9-CM‘P433’,’P436’,ICD- 10-AM ‘163’,‘164’diagnostic codes. Main outcome measured: Rate ratio (RR) of AMI and stroke were calculated using 1996 and 2001 Australian census data. Results: Male immigrants from three ethnic groups: USSR/Baltic (RR 3.91 95%CI 3.22,4.71), Southern Asia (RR 1.56 95%CI 1.31,1.85) and Middle East (RR 1.34 95%CI 1.10,1.63), consistently displayed higher risk for AMI (both years) than the Australian born cohort; while Southeast Asians (RR 0.51 95%CI 0.42,0.62) and Northeast Asians (RR 0.35 95%CI 0.24,0.50) were at lower risk. The findings for females were less consistent. North East Asian male and female immigrants (RR 0.57 95% CI 0.41, 0.76, RR 0.56 95%CI 0.41, 0.74), were consistently at lower risk for stroke than Australian born counterparts. Female immigrants from the Pacific Islands were consistently at higher risk (RR 1.52 95%CI 1.25, 1.84, RR 1.22 95%CI 0.98, 1.51) of stroke than Australian born women. Conclusion: A number of Non-Australian born adult males currently residing in Victoria are identified at increased risk of AMI, whereas few groups are at decreased risk, compared to Australian born males. North East Asian males and females were consistently at a lower risk for AMI and stroke than their Australian-born counterparts. However, Asia male and female immigrants are generally at a lower risk of stroke.