Background Lifetime risk estimation is used to predict long-term cardiovascular disease (CVD) risk across the entire life span. However, most of the lifetime risk estimation came from the studies based on western population. This study aimed to assess the lifetime risk of CVD and the impact of risk factors on lifetime risk of CVD in Chinese population. Design Prospective population-based cohort study. Methods The study sample came from the Chinese Multi-Provincial Cohort Study (CMCS), 21,953 participants aged 35 to 84 years without CVD at the baseline were included. The modified Kaplan-Meier method was used to calculate the lifetime risk of CVD. Results and conclusions During follow-up years from 1992 to 2010, 1,280 participants developed acute CVD events and 1,401 died. The lifetime CVD risk, up to age 80 for men and women at age 35, were 24.4% and 20.2% respectively. A very low lifetime risk was found in individuals with an optimal profile of risk factors which modified the effect of aging. By contrast, with two or more high risk factors the lifetime risk up to age 80 reached 51.1% for men and 38.6% for women at age 35. The integrated status of major CVD risk factors can determine lifetime cardiovascular health and CVD risk in Chinese. Early prevention with a goal of all risk factors at optimal levels should become the priority of CVD prevention in the future.