Rationale: Previous case-series have suggested that people with idiopathic pulmonary fibrosis may be at increased risk of vascular disease. Objectives: To quantify the risk of cardiovascular disease before and after a diagnosis of idiopathic pulmonary fibrosis. Methods: We have used computerised primary care data from the Health Improvement network to quantify the relative risk of having a cardiovascular event (acute coronary syndrome, angina, atrial fibrillation, deep vein thrombosis and cerebrovascular accident) either before or after having a diagnosis of idiopathic pulmonary fibrosis in comparison to age, sex and community matched general population controls. Results: Our study included 920 incident cases of idiopathic pulmonary fibrosis (mean age at diagnosis 71 years, 62% male) and 3593 matched controls. There was an increased risk of acute coronary syndrome (Odds Ratio 1.53, 95% confidence interval 1.15 to 2.03), angina (OR 1.84, 95% CI 1.48 to 2.29) and deep vein thrombosis (OR 1.98, 95%CI 1.13 to 3.48) in the period before the diagnosis of idiopathic pulmonary fibrosis. During the follow-up period there was a marked increased risk of acute coronary syndrome (Rate Ratio 3.14, 95%CI 2.02 to 4.87) and deep vein thrombosis (RR 3.39, 95%CI 1.57 to 7.28). None of these estimates were confounded by smoking habit or modified by age or gender. Conclusions: People with idiopathic pulmonary fibrosis have an increased risk of vascular disease in comparison to the general population. This effect is most mark for acute coronary syndrome and deep vein thrombosis after the diagnosis of idiopathic pulmonary fibrosis has been made.