Background: Cannabis use disorder (CUD) is growing more prevalent, particularly among the young, and has the potential to increase cardiac/ cerebrovascular disease risk. We sought to determine how obesity affects cardiovascular outcomes in young cannabis users. Methods: Using 2019's National Inpatient Sample and relevant ICD-10 codes, we identified and compared young (18-44 years) obese vs. non-obese patients hospitalized with CUD. The risks of all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE- all-cause mortality, AMI, cardiac arrest, and stroke) and sex/racial disparities were assessed in young CUD admissions with and without obesity after adjusting for confounders Results: Overall prevalence of obesity among the young CUD cohort (n:539125, Mean age 30 years) was 10.3 % (55725/ 539125). The obese cohort was relatively older (mean age 32 vs 30 years) and often had females (58.6 vs 42.2%), blacks (33.6 vs. 23.1%), patients from the lowest income quartile (0-25th) (43.2 vs 39.7%), western hospitals (23 vs 20.1%) with lower non-elective admissions (85.3 vs 88.2%). Hypertension, diabetes, hyperlipidemia, PVD, prior MI, TIA/Stroke were more frequently seen in the CUD-Obese cohort. The young obese cohort with CUD had significantly higher adjusted odds of MACCE (aOR1.41, 95%CI 1.25-1.60, p<0.001) even after controlling other confounders. Males (aOR 1.63, 95%CI 1.39-1.90, p<0.001) but not females, whites (aOR 1.56, 95%CI 1.29-1.89, p<0.001) and blacks (aOR 1.30, 95%CI 1.06-1.58, p=0.011) with obesity had a higher risk of MACCE vs. the non-obese cohort. However, all-cause mortality was not found to be significantly higher in the young obese cohort with CUD (aOR 1.14 95%CI 0.80-1.63, p=0.473) [Table 1] . Conclusions: Obese cannabis users are 41% more likely to have a MACCE event during hospitalizations. Prospective studies are needed to examine cardiovascular consequences in cannabis users with established CVD risk factors.