Data on never-smoking decedents from the 1986 National Mortality Followback Survey were used to perform a case-control analysis of ischemic heart disease in relation to spousal cigarette smoking. The case groups consisted of 475 men and 914 women who died from heart disease. Controls consisted of 998 men and 1930 women who died from other causes. In this study there was no association between spousal smoking and ischemic heart disease in either sex (males, odds ratio = 0.97; females, odds ratio = 0.99). The results of this study are in striking disagreement with risk elevations reported in several previous studies of spousal smoking and heart disease.