The aim of this study was to analyze the spatial distribution of mortality Ischemic Heart Disease (IHD) in 497 municipalities of the state of Rio Grande do Sul, Brazil, in year 2010. Geoda<sup>#8482;</sup> and QGIS 1.8 were used to perform Exploratory Spatial Data Analysis of the 7,821 deaths. The results showed a positive spatial autocorrelation regarding IHD mortality (I = 0.16236, p = 0.001) with the formation of three clusters of type High-High. Also occurred a significant positive association for three socioeconomic and demographic indicators and IHD mortality rate: School Index (I = 0.0901944, P = 0.001), GINI Index (I = 0.0695551, p = 0.001), and Geographic Distance (I = 0.0901944, P = 0.001). One indicator presented significant negative association with IHD mortality rate: City Development Index Human (I = -0.130376, P = 0.001). We conclude that high rates of IHD mortality in some regions of Rio Grande do Sul, is potentially determined by socioeconomic, demographic disparities and geographic distances between patients' city of residence and their corresponding Interventional Cardiology Reference Centers.