Objective To investigate the value of coronary CT angiography (CCTA) in interventional therapy of chronic total occlusion (CTO). Methods 78 patients with coronary heart disease CTO were divided into the success group (n=43) and the failure group (n=35) according to the success of interventional surgery. The characteristics of CTO were analyzed by CCTA, and the risk factors for failure of interventional therapy of CTO were screened by Logistic regression analysis. ROC curve was used to analyze the predictive efficiency of CT-CTO score and J-CTO score for the success of interventional therapy. Results The ratios of vascular occlusion length ≥ 20mm, moderate to severe calcification, severe distortion of occluded blood vessels, bifurcation of proximal occluded section and unclear fibrous cap of distal occluded section in the failure group were higher than those in the success group (P<0.05). Multivariate Logistic regression analysis showed that vascular occlusion length ≥ 20mm, severe calcification, bifurcation of proximal occluded section and unclear fibrous cap of distal occluded section were the influencing factors of interventional therapy failure (P<0.05). ROC curve analysis showed that the area under the curve of CT-CTO score for predicting the success of interventional therapy [0.751 (95% CI: 0.612~0.923)] was significantly larger than that of J-CTO score [0.732 (95% CI: 0.462~0.714)] (P<0.05). Conclusion To get the characteristics of CTO through CCTA can provide important information for predicting the success of interventional therapy for CTO.