The aim of the present study was to evaluate the association between meat consumption and the prevalence of a first, non-fatal event of an acute coronary syndrome (ACS), in a Greek sample.Randomized, case-control study.Tertiary care.A total of 848 out of 956 patients who had been randomly selected from hospitals with first event of an ACS and 1078 population-based controls, age and sex matched.Detailed information regarding their medical records, alcohol intake, physical activity and smoking habits was recorded. Nutritional habits were evaluated with a semiquantitative food-frequency questionnaire. Multiple logistic regression analysis estimated the odds ratio of having ACS by level of meat intake, after taking into account several confounders.Patients consumed higher quantities of meat compared with controls (6.5+/-2.9 vs 4.9+/-2.1 portions per month, P<0.001). Food-specific analysis showed that red meat consumption was strongly associated with 52% increased odds of ACS (95% confidence interval (CI) 1.47-1.58). On the contrary, white meat consumption seems to be associated with only 18% likelihood of having cardiac events (95% CI 1.11-1.26). Participants who consumed >8 portions red meat and >12 portions white meat per month had 4.9 times and 3.7 higher odds of having ACS, respectively (P<0.001), compared with low meat intake (<4 portions and <8 portions per month, respectively).Increased red meat consumption showed a strong positive association with cardiac disease risk, whereas white meat consumption showed less prominent results, after controlling for several potential confounding factors.