Objective To compare the application of coronary angiography (CTA) and electrocardiogram in the diagnosis of patients with latent coronary heart disease. Methods The clinical data of 120 patients with latent coronary heart disease admitted to our hospital were retrospectively analyzed. All patients were given CTA, dynamic electrocardiography and CAG. The CAG results were used as the gold standard to evaluate the sensitivity, specificity, positive (negative) predictive value and Kappa value (consistency) of CTA and dynamic electrocardiogram in the screening of coronary heart disease. Results With CAG as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and the Kappa value of CTA in the diagnosis of coronary stenosis were 0.981, 0.867, 0.967, 0.981, 0.867 and 0.848, and CTA and CAG had good consistency. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and the Kappa value of dynamic electrocardiography in the diagnosis of coronary stenosis were 0.971, 0.533, 0.917, 0.936, 0.727 and 0.570, and the dynamic electrocardiogram and CAG had general consistency. The sensitivities of CTA in the diagnosis of mild, moderate and severe stenosis were 0.995, 0.979 and 0.944 respectively. Dynamic electrocardiography showed that myocardial ischemia site was associated with stenotic vessels in CAG. Conclusion CTA and dynamic electrocardiogram have certain clinical value in the diagnosis of latent coronary heart disease. CTA has higher diagnostic sensitivity and better consistency with gold standard, and dynamic electrocardiogram can be used for initial screening of asymptomatic myocardial ischemia.