Computerized electrocardiogram (ECG) may be extremely useful to develop new tools for the definition of the risk and the prevention of cardiovascular disease. The Moli-sani project (http://www.moli-sani.org) is a population-based cohort study that recruited over 24.000 men and women, aged >35 year, from the general population. The aim was the evaluation of risk factors linked to chronic-degenerative disease with particular regard to cardiovascular disease and cancer and intermediate metabolic phenotypes such as hypertension, diabetes, dyslipidemia, obesity, and metabolic syndrome. Standard 12-lead resting ECG was performed by a Cardiette ar2100-view electrocardiograph and tracings stored in digital standard communication protocol format for subsequent analysis. The digital ECG database of the Moli-sani project is currently being used to assess the association between physiologic variables, pathophysiologic conditions such as hypertension, diabetes and obesity and parameters derived from the ECG signal. This is a comprehensive review of the database and of the results until now obtained with its analysis.