The importance of body fat distribution as one determinant of various metabolic disorders associated with obesity is now recognized and some epidemiological evidence exists that it might be related to the onset of coronary heart disease (CHD) in men and women. The Paris Prospective Study data permitted exploration of the relationship between three subsets of anthropometric upper versus lower body measurements (waist-thigh circumferences, subumbilical-thigh skinfolds, bideltoid-bitrochanter diameters) and CHD risk in a middle-aged male population. The analysis successively disclosed the simple measurement ratio for both girth and diameters and the subumbilical2: thigh skinfold ratio as the best predictors of CHD outcome. The girth and skinfold but not the diameter ratios were positively correlated with body mass index and usual CHD risk factors except smoking. The relationship of upper versus lower fat localization (girth and skinfold ratios) with CHD incidence confirmed previous results obtained in this population but its magnitude is low in comparison with usual CHD risk factors. The association of the diameter ratio as an index of upper body frame with CHD occurrence remains to be confirmed by further studies.