Objective To evaluate the correlation between the severity of coronary artery stenosis and ascending aortic elasticity by using MDCT. Methods A total of 138 patients with coronary artery disease underwent 320-MDCT coronary angiography. According to the presence of coronary artery stenosis they were divided into coronary stenosis group and no coronary stenosis group, according to the extent of coronary stenosis were divided into mild stenosis and moderate-severe stenosis group; ascending aorta elastic parameters and the Gensini score were compared between different groups. Results The AoD of Coronary stenosis group was significantly lower than that of no stenosis group. AoS and the Gensini score were significantly higher than no stenosis group (P<0.05). Mild group AoD was significantly higher than that of moderate- severe group, AoS and Gensini score were significantly lower than the moderate-severe group(P<0.05). ROC curve was used to evaluate AoD, AoS predicting coronary artery disease and the area under the curve (AUC) was directly 0.94, 0.89. Conclusion The elasticity of ascending aorta is closely related to the extent and extent of coronary stenosis, and may be an independent predictor of coronary artery disease.