BackgroundSeveral sex-specific risk factors (SS-RFs) increase a women’s risk for cardiovascular disease (CVD) but are often overlooked during risk assessment. The purpose of this study was to identify the prevalence of SS-RFs and assess CVD risk, knowledge, perceptions and behaviours in premenopausal Canadian women. MethodsAn online survey was distributed across Canada to premenopausal biological females (19-49 years of age). The survey gathered demographics, medical history, engagement in health-promoting behaviours, and knowledge and perceptions of CVD risk. CVD risk was calculated using medical risk and SS-RFs were tabulated from medical history. ResultsA total of 2559 participants (33 ± 8 years) completed the survey. The majority of our sample (82%) was classified as low medical risk. Of those classified as low risk, 35% had at least 1 SS-RF. Of high-risk individuals, 70% underestimated their risk, 21% of whom perceived themselves as low risk. Engagement in health behaviours was suboptimal. Knowledge of traditional CVD risk factors and prevention was relatively high; however, less than one-half were aware of SS-RFs such as early menopause (39.4%). ConclusionsConsidering both traditional and SS-RFs, 47% of premenopausal Canadian women may be at risk for developing CVD. Of those deemed low medical risk for developing CVD, more than one-third reported having at least 1 SS-RF. Canadian women have poor knowledge of the risks associated with SS-RFs, lack sufficient awareness of the need for prevention of CVD, and are not engaging in sufficient health-promoting behaviours to mitigate future CVD risk.