Objective To analyze the value of 12-lead dynamic electrocardiogram (DCG) and treadmill exercise test (TET) in the diagnosis of coronary heart disease. Methods The clinical data of 140 patients who were proposed to diagnose as coronary heart disease were retrospectively analyzed. All patients were given DCG and TET and selective coronary angiography (CAG). CAG was taken as the gold standard, and the sensitivity, specificity, positive (negative) predictive value and Kappa value (consistency) of DCG and TET were evaluated in the diagnosis of coronary heart disease, and the detection rates of the two methods were compared. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa value of DCG in the diagnosis of coronary heart disease were 0.957, 0.625, 0.930, 0.967, 0.556 and 0.550, and its consistency was general with the CAG. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa value of TET in the diagnosis of coronary heart disease were 0.946, 0.875, 0.940, 0.989, 0.583 and 0.668, and the consistency of TET and CAG was general. The detection rate of coronary heart disease by DCG was 91.00%, and the detection rate by TET was 88.00% (P>0.05). Conclusion Both 12-lead dynamic electrocardiogram and treadmill exercise test can be used as effective methods for diagnosing coronary heart disease.