The projected incidence of cardiovascular disease (CVD) in male firefighters was determined by the prevalence of current CVD risk factors and the use of the Framingham Study general cardiovascular risk profile in a probability sample of firefighters from two municipal fire departments. Hypercholesterolemia (60.9%) and obesity (56.0%) were the most prevalent risk factors. Significant age-related trends were observed for the prevalence of all CVD risk factors, except glucose intolerance (P = .21) and an abnormal resting electrocardiogram (P = .07). The projected incidence of CVD in firefighters did not differ from that of the general male population (relative risk, 1.0; 95% confidence interval, 0.7 to 1.4); similar risk estimates were observed in age-specific analyses. These findings are in accord with previous incidence and mortality studies that used circulatory diseases as an end point. The present method should be viewed primarily as a hypothesis-generating tool because of its limitations in assessing cause and effect.