<p>The coronary artery disease is prevalent among young population. This study evaluated the associations between dietary intakes, sociodemographic and lifestyle factors with lipid profile in young adults with premature coronary artery disease (PCAD). This cross-sectional study included 141 individuals with PCAD. Sociodemographic, lifestyle, dietary, anthropometric, and biochemical profiles were assessed. Statistical analyses included chi-square tests, t-tests, and regression modeling. The mean age was 30 ± 3.9 years. Among participants, 66% had BMI ≥ 25&#xa0;kg/m² and 79% had Waist to hip ratio &gt; 0.9 (WHR). Around 59% had high low-density lipoprotein (LDL), 54% had high triglycerides and 59% had low high-density lipoprotein. Higher BMI was found to be associated with increased odds of elevated LDL cholesterol (OR 1.73, 95% CI 1.18–2.54, <i>p &lt;</i> 0.001) and triglyceride levels (OR 1.55, 95% CI 1.04–2.31, <i>p &lt;</i> 0.05) even after adjustment for age and sex. WHR showed a positive association with cholesterol (OR 1.64, 95% CI 1.07–2.51, <i>p &lt;</i> 0.05), LDL (OR 1.49, 95% CI 1.04–2.14, <i>p &lt;</i> 0.05) and triglycerides (OR 1.42, 95% CI 1.0–2.02, <i>p</i> = 0.053) in unadjusted models. About 32.7% reported breakfast skipping which was associated with higher triglyceride (<i>p &lt;</i> 0.05). Non-vegetarian diet was prevalent (92%), with mixed consumption of chicken, mutton and fish (29%) associated higher cholesterol (<i>p &lt;</i> 0.05). Energy-dense foods (sweets, bakery, beverages) were consumed frequently. The regular jogging was inversely related to obesity (<i>p &lt;</i> 0.05). Short sleep (≤ 4&#xa0;h) was associated with higher cholesterol (<i>p &lt;</i> 0.01), while long sleep (10&#xa0;h) was linked with normal BMI (<i>p &lt;</i> 0.05). Young adults with PCAD exhibited high general and central obesity, dyslipidemia and unhealthy dietary and activity patterns. These findings underscore the need for early lifestyle interventions to reduce the burden of PCAD.</p>