BACKGROUND: Cardiovascular diseases (CVDs) are the main causes of death worldwide, including in the hajj pilgrims. Coronary heart disease (CHD) is the most common CVDs in Indonesian hajj pilgrims hospitalized in Saudi Arabia. AIM: This study aimed to determine the determinants of the CHD incidence among Indonesian hajj pilgrims hospitalized in Saudi Arabia in 2019. METHODS: This study was an observational analytic study with a case–control design. The study was conducted in Makassar using data from the integrated Hajj computerized system in the health sector (siskohatkes) Hajj Health Center (Puskeshaji) in January–June 2021. Cases were pilgrims hospitalized in Saudi Arabia with a diagnosis of CHD, about 186 people, and controls were pilgrims hospitalized with diagnoses other than CVDs. Selection of controls by matching age and sex with a ratio of 1:1. The determinants analyzed included education, high blood pressure, high blood sugar levels, high low-density lipoprotein (LDL) cholesterol levels, excess body mass index (BMI), and smoking. Data analysis was using the STATA program with an odds ratio (OR) test and multiple logistic regression. RESULTS: The most respondents were 65 years (48.39%), female respondents, about 61.83%. Most respondents’ education was in elementary school, about 31.99%. Multivariate analysis showed that high blood pressure (OR = 2.32, 95% confidence index [CI] = 1.50–3.57), high blood sugar levels (RO = 1.90, 95% CI = 1.06–3.40), high LDL cholesterol levels (RO = 1.82, 95% CI = 1.15–2.88), and excess BMI (RO = 1.73, 95% CI = 1.07–2.68) were risk factors for the CHD incidence. However, education and smoking were not risk factors for CHD. CONCLUSION: By multiple logistic regression analyzes, the study revealed that the probability of CHD when having those four risk factors was 85.69%.