Intense domestic physical activity (IDPA) is promoted by preventive health campaigns, but this recommendation is not supported by evidence. The authors used data from the 1995, 1998, and 2003 Scottish Health Survey samples and the associated mortality and hospital episode records to determine the independent effects of IDPA on cardiovascular disease (CVD) events and all-cause mortality. The sample comprised 13,726 (6,102 men) CVD-free respondents (> or =35 years). Multivariable survival analysis assessed the relation between IDPA and the risk for CVD (fatal/nonfatal combined) or all-cause mortality. During 8.4 (standard deviation, 3.4) years of follow-up, there were 1,103 deaths (573 among men) and 890 CVD events (521 among men). Participation in IDPA was associated with lower all-cause mortality (men: relative risk = 0.68, 95% confidence interval: 0.50, 0.91; women: relative risk = 0.70, 95% confidence interval: 0.52, 0.93). In both sexes, IDPA was unrelated to the risk for CVD. Total physical activity (including IDPA) was unrelated to fatal/nonfatal CVD, but when domestic activity was excluded from the calculations there was an association (men: relative risk = 0.76, 95% confidence interval: 0.58, 0.98; women: relative risk = 0.68, 95% confidence interval: 0.50, 0.93). These results indicate that IDPA may not offer protection against CVD, but it may protect against all-cause mortality. CVD preventive efforts may need to focus on moderate-to-vigorous-intensity physical activities other than those performed in and around the household.