Background: Consanguineous marriage is an established factor associated with CHD. Because cousin marriages are practiced in all parts of the country, it was needed to study the association of consanguineous marriages and CHD in the context of Afghanistan. Methodology: A case-control study design was employed to conduct the study. 200 individuals with CHD and 200 individuals without CHD (controls) were selected from three well known cardiac centres in Kabul. Data was collected with interview through structured questionnaire. The data was then analysed by logistic regression to find association between consanguinity and CHD in the presence of other risk factors. Results: The results showed that gender distribution was the same in both cases and controls. The most common CHD in the current study was VSD. The Findings revealed that consanguinity was associated with CHD with OR = 2.1 and 95% CI = 1.36 – 3.23.Other factors significantly associated with CHD were family history of CHD, education of the parents and age of the mother at marriage. Conclusion: the findings of the study suggest that consanguinity increases the risk of having a CHD by two times. Because cousin marriages are common in Afghanistan, there is an urgent need to educate people on consequences of cousin marriages and at the same time strengthen the health care system for its timely diagnosis and treatment.