The aim of this study was to assess whether psychosocial factors and health-related quality of life (HRQL) differ between Roma and non-Roma coronary patients and to what degree socioeconomic status (SES) explains these differences. We included 138 patients out of 437 interviewed: 46 Roma, all with low SES, 46 non-Roma with low SES, and 46 non-Roma with high SES. Groups were matched for age, gender and education. The GHQ-28 was used for measuring psychological well-being, the Maastricht interview for vital exhaustion, the type D questionnaire and the Cook-Medley scale for personality and the SF-36 for HRQL. SES was indicated by income and education, and disease severity by ejection fraction. ANOVA and linear regression were used. Roma scored poorly compared to non-Roma in psychological well-being, vital exhaustion and HRQL (p a parts per thousand currency sign 0.001); however, these differences could be to a substantial extent explained by SES. With regard to personality traits, ethnicity and SES played a less significant role. The adverse quality of life among Roma coronary patients may warrant additional care, which should target their low SES but also other factors related to their ethnic background, such as culture and living conditions