Objective To explore the correlations between gene polymorphisms of triggering receptor expressed on myeloid cells-1 (TREM-1) rs9471535 and susceptibility to male premature coronary artery disease (PCAD).Methods Between August 2015 and January 2017, male inpatients aged 55 or above, treated at the Department of Cardiology of our hospital, and identified by coronary angiography or CTA with CAD (PCAD group) or without CAD (control group), were enrolled into this study. The DNA kit was used to extract DNA from peripheral venous blood, and polymerase chain reaction-ligase detection reaction (PCR-LDR) technology was used to identify the TREM-1 gene polymorphisms. The frequencies of genotypes and alleles of rs9471535 were calculated and binary logistic regression was used to analyze the relationships between rs9471535 polymorphisms and susceptibility to PCAD.Results The percentages of patients with hypertension (57.0%), diabetes (21.5%), hyperlipidemia (59.5%) or with smoking history (74.4%) were significantly higher in the PCAD group than those in the control group (P<0.05). The frequencies of genotypes TT(46.3%), CT (50.4%)and CC (3.3%)of rs9471535 in the PCAD group were significantly different from those of the control group, which were 51.0%, 38.3%,and 10.7% respectively(P=0.017). According to univariate analysis with binary logistic regression, as compared with TT genotype, the distribution of CC genotype was not significantly different between the two groups (P=0.059,OR=0.340,95%CI=0.111-1.041). However, after adjustment of traditional risk factors (age, hypertension, diabetes, hyperlipidemia and smoking), carriers of CC genotype had lower risk of PCAD (P=0.011,OR=0.180,95%CI=0.048-0.679).Conclusions The TREM-1 gene rs9471535 polymorphism may have correlations with the occurrence of male premature CAD. Individuals with CT and TT genotypes may be more vulnerable to premature CAD than those carrying CC genotype that may play a protective role in male PCAD.