Abstract: Objective To study the aero-medical assessment principles of coronary myocardial bridge（CMB） in pilots by analyzing its clinical characteristics. Methods Clinical data about 15 pilots with CMB diagnosed by coronary angiography or spiral CTA in our hospital during the recent 5 years were retrospectively analyzed and its aero-medical assessment principles were put forward in accordance with an review of its related literature. Results CMB was frequently observed in pilots with ST-T change on ECG or at positive treadmill exercise testing,accounting for about 30% in those with abnormal ECG.CMB,usually located in the middle or distal segment of left anterior descending coronary artery,was mainly manifested as a superficial type with no obvious symptoms or as arrhythmia,interrupted chest distress or pain in a small number of patients.Since superficial CMB did not affect cardiovascular function,pilots with superficial CMB were qualified to fly a double-seat airplane while whether those flying a single-seat airplane should be assessed individually if the treatment outcome was good. Conclusion CMB is the common cause of abnormal ECG in pilots and usually manifested as a superficial type which does not affect cardiovascular function and flying.Pilots with clinical symptoms of CMB should be assessed individually according to their treatment outcome and the types of airplane they fly.