BACKGROUND: To assess whether a banking system crisis increases short-term population cardiovascular mortality rates. METHODS: International, longitudinal multivariate regression analysis of cardiovascular disease mortality data from 1960 to 2002 RESULTS: A system-wide banking crisis increases population heart disease mortality rates by 6.4% (95% CI: 2.5% to 10.2%, p < 0.01) in high income countries, after controlling for economic change, macroeconomic instability, and population age and social distribution. The estimated effect is nearly four times as large in low income countries. CONCLUSION: Banking crises are a significant determinant of short-term increases in heart disease mortality rates, and may have more severe consequences for developing countries.