Cigarette smoking is a major cause of cardiovascular disease and is responsible for approximately 140,000 premature deaths from cardiovascular diseases each year. Cigarette smoke delivers a high concentration of oxidizing chemicals and exposure to these chemicals is associated to depletion of endogenous levels of antioxidants, which contribute to a number of the potential mechanism of cardiovascular disease. Altered blood coagulation, impaired integrity of the arterial wall, and changes in blood lipid and lipoprotein concentrations predisposes to coronary artery disease (CAD) in smokers. Aims and objective: To compare lipid profile in smokers and nonsmokers. Determine dose-dependent relationship, durational significance between smoking and lipid profile among smokers. Evaluation for CAD in both smokers and nonsmokers. Materials and methods: The study was carried out in 100 healthy male smokers and 100 healthy male nonsmokers selected from volunteers from RajaRajeswari Medical College, Bengaluru. All patients were subjected to fasting lipid profile, cardiac evaluation by doing ECG/ECHO/TMT in smokers and nonsmokers. Results: The mean duration of smoking was 6.6 years. The mean level of total cholesterol, LDL cholesterol, and triglycerides is significantly increased (p value > 0.001), whereas the mean level of HDL cholesterol is significantly low (p value > 0.001) in smokers compared to nonsmokers. There is a direct relationship exist between the severity of smoking and an increase in serum lipids. We have observed ECHO and TMT changes in smokers who have smoked for a duration of >6 years. Conclusion: We have observed that there is a direct relationship exists between the severity of smoking and an increase in the serum lipid profile levels as well as greater risk for the development of coronary heart disease. So, it is strongly recommended to avoid smoking for the benefit of cardiac health.