We have conducted a historical cohort study to assess cardiovascular mortality among psoriasis patients. Using the Swedish Inpatient Registry, we selected 8991 patients hospitalized for psoriasis at dermatological wards. To represent an outpatient cohort, 19,757 members of the Swedish Psoriasis Association were selected. Mortality from cardiovascular diseases was compared with the general population. We found no increased cardiovascular mortality among outpatients with psoriasis (standardized mortality ratio, SMR 0.94; 95% confidence interval, CI: 0.89–0.99). The overall risk among inpatients admitted at least once was increased by 50%(SMR 1.52; 95% CI: 1.44–1.60). The excess risk increased with increasing number of hospital admissions (p for trend <0.001). cardiovascular="" mortality="" was="" higher="" among="" those="" admitted="" at="" younger="" ages="">p for trend <0.001; smr="" 2.62,="" 95%="" ci:="" 1.91–3.49,="" for="" patients="" aged="" 20="" to="" 39="" years="" at="" first="" admission).="" young="" age="" at="" first="" admission="" appeared="" to="" further="" increase="" the="" risk="" among="" those="" who="" were="" repeatedly="" admitted.="" we="" conclude="" that="" a="" diagnosis="" of="" psoriasis="">per se does not appear to increase the risk for cardiovascular mortality. Severe psoriasis, however, here measured as repeated admissions, and early age at first admission, is associated with increased risk for cardiovascular death.