Abstract: Objective To explore clinical application value of 64-slice CT coronary angiography (CTCA) in diagnosis of coronary artery diseases with chest pain as the chief complaint. Methods In accordance with the chief complaint with or without chest pain,105 hospitalized patients with CTCA examination were divided into chest pain group and non-chest pain group.In addition to the general information of patients,the difference in coronary artery diseases such as the positive rate,the plaque composition,the plaque segment quantity and the degree of stenosis between two groups was compared retrospectively. Results Among 56 patients with chest pain,45 cases were diagnosed with coronary artery plaque as 176 segments in total were observed,including 77 non-calcified plaques,64 calcified plaques and 35 mixed plaques.Insofar as stenosis was concerned,11 patients were found at level 0,33 patients at level 1,6 patients at level 2 and 6 patients at level 3.Among 49 patients without chest pain,23 cases were diagnosed with coronary artery plaque as 69 segments in total were observed,including 44 non-calcified plaques,17 calcified plaques and 8 mixed plaques.Insofar as stenosis was concerned,26 patients were found at level 0,18 patients at level 1,1 patients at level 2,4 patients at level 3.Gender between two groups had no significant statistical difference (χ²=3.26,P=0.07);the average age between two groups had no significant statistical difference (t=0.64,P=0.52);the positive rate of chest pain group were higher than non-chest pain group (χ²=12.79,P<0.001);plaque composition had significant statistical differences (χ²=8.03,P=0.02);the plaque segment quantity had significant statistical differences (Z=-3.71,P<0.001);the degree of luminal stenosis had significant statistical differences (Z=-3.33,P<0.001),the mean rank of chest pain group was 61.48,higher than 43.31 of non-chest pain group. Conclusion CTCA showed that the positive plaques,the plaque segment quantity and the degree of luminal stenosis in patients with chest pain were higher than those in patients without chest pain.In addition,plaque composition between two groups had significant statistical difference.Therefore,CTCA has important clinical value in diagnosis of coronary artery diseases with chest pain as the chief complaint.