Objective: To study clinical application value of 320-slice spiral computed tomography (SCTCA) for diagnosing coronary artery disease. Methods: A total of 85 patients underwent 320-slice spiral CT and selective coronary angiography (CAG). With CAG as gold standard for diagnosing coronary heart disease (CHD), sensitivity, specificity, positive predictive value, negative predictive value and accuracy were compared between 320- SCTCA and CAG. Results: Sensitivity was 95.65%, specificity was 74.36%, positive predictive value was 81.48%, negative predictive value was 93.55% and accuracy was 85.9% diagnosing coronary artery disease by 320-slice spiral CT. Conclusion: 320-slice spiral computed tomography is a simple, safe, reliable non-invasive measurement, may be used for screening coronary heart disease and reviewing after operation.