Fibroblast growth factor receptor 4 (FGFR4) plays crucial roles in vascular smooth muscle cell proliferation and atherosclerosis and, therefore, may potentially affect the development of coronary artery disease (CAD). The aim of this study was to investigate the association between FGFR4 polymorphisms and the susceptibility to CAD in the Chinese population. Two polymorphisms, rs192201146G/A (Asp756Asn) and rs188755817C/G (Ser778Arg), were detected by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing in 722 CAD cases and 802 age-matched controls. Data were analyzed using the chi-square test. Results showed that frequencies of rs192201146GA genotype and rs188755817CG genotype were significantly higher in CAD patients than in controls (odds ratio [OR] = 1.92, 95% confidence interval [CI] 1.11-3.28, p = 0.016, and OR = 1.87, 95% CI 1.06-3.30, p = 0.027). Similarly, numbers of the rs192201146A allele and the rs188755817G allele were significantly increased in CAD cases (OR = 1.89, 95% CI 1.11-3.22, p = 0.017, and OR = 1.85, 95% CI 1.06-3.24, p = 0.029). Haplotype analysis revealed that GG and AC (rs192201146 rs188755817) haplotypes had higher frequencies in CAD patients (OR = 2.75, p = 0.002 and OR = 2.69, p = 0.001). Our data suggested that the FGFR4 rs192201146 (Asp756Asn) and rs188755817 (Ser778Arg) polymorphisms could act as risk factors for CAD in the Chinese population.