A high-cholesterol diet has been associated with an increased risk of coronary heart disease, but it is unclear whether all high-cholesterol foods increase the risk of heart disease. The purpose of this study is to determine whether shellfish consumption is associated with an increased risk of coronary heart disease. Analysis was performed on the Atherosclerosis Risk in Communities study, a cohort of middle aged and elderly adults in the United States. The association between reported shellfish consumption to the development of coronary heart disease was examined. The cohort was divided into low, medium, and high shellfish consumers. There were 13,355 participants meeting our inclusion criteria, of which 1,382 suffered a coronary heart disease event. Using low shellfish consumers as the reference group, the medium shellfish consumers had an unadjusted hazard ratio of 0.89 (95% confidence interval [CI] 0.79 to 1.00), and the high shellfish consumers had an unadjusted hazard ratio of 0.91 (95% CI 0.80 to 1.03) of suffering a coronary heart disease event. In a model that was adjusted for age, sex, race, smoking status, body mass index, diabetes, hypertension, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, family history of early heart disease, and exercise status using the low shellfish consumers as the reference group, medium shellfish consumers had a hazard ratio of 0.96 (95% CI 0.80 to 1.16), and the high shellfish consumers had a hazard ratio of 0.98 (95% CI 0.82 to 1.18) of experiencing a coronary heart disease event.