Introduction: Cardiovascular diseases (CVD) have been recognized as the leading causes of death worldwide and in Iran. Deaths from CVD diseases accounted for approximately 39. 42% of Razavi Khorasan Province (RKP). This study aimed to evaluate the risk factors associated with CVD mortality in the residents of RKP. Method: This retrospective cohort study was conducted based on recorded information from the Vic Chancellery of Health Questionnaires of KRP (2016–, 2019). Results: This study was conducted on 2, 304, 156 participants. CVD deaths made up about 50% of total deaths. The opium use, history of heart attack, BMI ≥, 40kg/m2, homemade alcohol, FBS mg/dL >126, diabetes, BMI ≥, 30kg/m2, permanent use of salt, Systolic blood pressure, Framingham risk score, and age were CVD risk factors, respectively (OR 6. 59, 4. 91, 3. 25, 2. 64, 2. 00, 1. 99, 1. 89, 1. 80, 1. 09, 1. 04, and 1. 03, P = 0. 001). In addition, higher educational level, female gender, BMI 25-27kg/m, healthier eating habits (higher consumption of dairy, fruits, and vegetables), moderate exercise, and aspirin use were identified as protective factors. Conclusion: This study identified the demographic, behavioral, anthropometric and biochemical risk factors and preventive factors of CVD in RKP. These findings might justify the high incidence of sudden death in some cities of RKP like Dargaz.