This paper compares body mass index, waist circumference, hip circumference, and waist-hip ratio as risk factors for ischaemic heart disease and stroke in Asia Pacific populations. We undertook a pooled analysis involving six cohort studies (45 988 participants) and used Cox proportional hazards regression to assess the associations of the four anthropometric indices with stroke and ischaemic heart disease by age, sex and region. During a mean follow-up of six years, 346 stroke and 601 ischaemic heart disease events (fatal and non-fatal) were documented. Overall, a one-standard deviation increase in index was associated with an increase in risk of ischaemic heart disease of 17% (95% CI 7-27%) for body mass index, 27% (95% CI 14-40%) for waist circumference, 10% (95% CI 1-20%) for hip circumference, and 36% (95% CI 21-52%) for waist-hip ratio. There were no significant differences between age groups, sex, and region. None of the four anthropometric indices had a strong association with risk of stroke. These data indicate that measures of central obesity such as waist circumference and waist-hip ratio are strongly associated with risk of ischaemic heart disease in this region. Therefore, we suggest that, along with calculation of body mass index, measures of central obesity such as waist circumference and waist-hip ratio should be undertaken routinely.