Angiogenesis plays a pivotal role in the development of colon cancer during the promotion and metastasis of tumor growth. Vascular endothelial growth factor (VEGF) is known to be a potent angiogenic factor. This hospital-based case-control study was carried out to decide where there existed an association between the VEGF -1154G>A polymorphism and the susceptibility to colon cancer. DNA samples taken from 278 colon cancer patients and 226 healthy controls were studied using with real-time PCR for VEGF -1154G>A polymorphism. Genotype frequencies of the VEGF -1154G>A polymorphism were significantly different between patient and control groups (adjusted OR=2.735, 95% CI=1.243-6.015 for AA vs. GG genotype). In addition, upon stratification by gender and age, the frequencies of the A allele-bearing genotypes significantly increased the risk for development of colon cancer in men and patients younger than 55 years (in men, adjusted OR=3.375, The first two authors, YSC and JKC, contributed equally to this work. , and in <55 years, adjusted OR=4.908, 95% CI=1.294-18.617). Also, upon stratification of patients with proximal and distal colon cancer individually, the association only showed these significant patterns in distal colon cancer. This study provides evidence that VEGF -1154G>A polymorphism, at least in Koreans, might be associated with risks of the colon cancer, particularly in males.