Objective: Current literature has suggested an association between low vitamin D serum levels and the burden of cardio-metabolic risk factors. In the context of the high prevalence of vitamin D deficiency in Saudi Arabia, this study hypothesized that vitamin D deficiency is associated with increased risk of cardio-metabolic risk factors, such as obesity, diabetes, hypertension, and hypercholesterolemia among Saudi adults with coronary heart disease (CHD) compared with subjects without CHD. Methods: A total of 130 CHD subjects and 195 subjects without CHD were recruited from three hospitals in the western region of the Kingdom. Fasting blood samples were taken to measure serum levels of vitamin D, glucose, and total cholesterol from each subject. Anthropometric and blood pressure measurements were also measured. Results: The results indicated that vitamin D deficiency [serum 25(OH)D < 20 ng/mL] was associated with increased risk of diabetes in CHD subjects (OR: 2.8, 95% CI: 1.02-7.7, P=0.044), while there was no association observed in subjects without CHD. No significant associations were found between other cardio-metabolic risk factors and vitamin D deficiency in both groups. Conclusion: The current study revealed that diabetes was found to be inversely associated with vitamin D deficiency and this association was present only in subjects with CHD. Key words: Vitamin D deficiency, diabetes, obesity, Saudi Arabia, hypertension, Middle East, hypercholesterolemia.