Adiponectin (APN) is a cardioprotective polypeptide secreted by adipose tissue. Its gene is polymorphic. Three polymorphic loci, located in promoter region (rs266729), exon region (rs2241766) and intron region (rs1501299) respectively, are widely reported to be significantly associated with coronary heart disease (CHD). Other polymorphisms such as rs12495941, rs822395, rs182052, rs3774261 and rs17366568 were also reported to be significantly associated with CHD. In mechanisms, the polymorphisms of APN gene increased the risk of CHD mainly by reducing plasma APN level, causing lipid disorders, elevating blood pressure and promoting obesity. This article reviews the relationship between the polymorphisms of APN gene and CHD, as well as the underlying mechanisms.