Objective Analyze the value of multi-slice spiral CT（128-MSCTA） and selective coronary arteriography （CAG）in the diagnosis of coronary heart disease. Methods Randomly selected 1640 patients who came to the cardiovascular department of our hospital and meet the conditions of the our study.The1640 patients all accepted both the multi-slice spiral CT and selective coronary angiography.Finally we got 3168 stenosis artery segment and compared the diagnosis of stenosis degree, consistency between 128- MSCTA and CAG and diagnosis accuracy of multi slice spiral CT. Results The number of 128-MSCTA diagnosis of 0 grade,1 grade, 2 grade, 3 grade and 4 grade stenosis were 1152 cases, 396 cases, 564 cases, 564 cases and 492 cases respectively; CAG were 1164 cases,360 cases, 516 cases, 612 cases and 516 cases.Comparison of the two methods had no statistical significance (P>0.05). Two methods diagnosed stenosis of 0 grade, 1 grade, 2 grade, 3grade and 4 grade respectively had consistency, the Kappa values were 0.96, 0.87, 0.89, 0.87 and 0.94, the consistency of two methods is good(Kappa>0.75).The highest sensitivity of Multi slice spiral CT in diagnosis of coronary heart disease was grade 0, 97.91%; the highest specificity is grade 1, 99.13%;the highest positive predictive value is grade 0, 96.91%; the highest negative predictive value is grade 4, 99.55%. Conclusion Multi slice spiral CT in diagnosis of coronary heart disease and in judgement of the degree of coronary artery stenosis have consistency with selective coronary arteriography . 128- MSCTA is a way of little trauma and safety, which is worthy of using.