No epidemiological studies on cardiovascular disease (CVD) were conducted on Hmong refugees arriving to the U.S. from 1970s to 1990s. This study measured prevalence of CVD and CVD risk factors in Hmong refugees newly arriving from Wat Tham Krabok, Thailand 2004-2006. Cross-sectional study of 1,462 Hmong refugees who received refugee screening exams at seven primary care clinics in St. Paul MN, June 2004-March 2006. In younger age group (N = 988, 0-20 years old), overweight equaled 13.7%, hypertension = 8.2%, pre-hypertension = 9.6% and in a subset, hyperglycemia equaled 20.7% and hyperlipidemia = 13.5%. In older age group (N = 448, >20 years old), overweight equaled 33.4%, obese = 14.8%, hypertension = 16.5%, and pre-hypertension = 36.2%. In a subset, diabetes mellitus = 2.8%, hyperglycemia = 31.7%, hyperlipidemia = 25.8%, renal insufficiency = 9%, and hyperuricemia = 11.7%. Hmong refugees had significant CVD risk factors on arrival. Healthcare providers and public health officers must identify CVD in addition to infectious diseases when refugees arrive in the U.S. and must address long-term care in order to forestall the development of CVD.