Abstract Previous studies have mainly explored the effects of body mass index (BMI) and triglyceride-glucose index (TyG index) on cardiovascular disease (CVD) separately or by examining the composite parameter (TyG-BMI) formed by multiplying the two and its association with CVD. However, few studies have investigated the combined effect of BMI categories and the TyG index on CVD. This study aimed to determine the association of BMI categories combined with the TyG index in new-onset CVD. A total of 94,002 participants were included from the Kailuan study. Their BMI combined with the TyG index was categorized into six groups: Low-BMI/Low-TyG, Middle-BMI/Low-TyG, High-BMI/Low-TyG, Low-BMI/High-TyG, Middle-BMI/High-TyG, and High-BMI/High-TyG. A multifactorial Cox proportional hazards model was used to analyze the longitudinal association between BMI combined with the TyG index and new-onset CVD events. During a follow-up period of 15.95 ± 3.59 years, 9791 new CVD events were recorded. After adjusting for confounding factors such as sex, age, smoking, drinking, physical activity, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, high-sensitivity C-reactive protein, antihypertensive drugs, hypoglycemic drugs, and lipid-lowering drugs, Cox regression analysis showed that the risk of CVD events was 52% higher in the High-BMI/High-TyG group (HR: 1.52; 95% CI 1.42–1.64) compared to the Low-BMI/Low-TyG group. The combination of high BMI (≥ 28.0) and high TyG index (> 8.58) significantly increases individual CVD risk. This study suggests that the combination of BMI and the TyG index may better help identify individuals at risk of developing CVD.