Abstract: Objective To evaluate the application of intravenous esmolol in low dose, high-pitch dual-source CT coronary angiography (Double Flash). Methods Three hundred and nineteen patients who received Double Flash with heart rates under 65 beats/min before scanning from March to October in 2013 in Chinese PLA General Hospital were enrolled in this study and divided into two groups. Group A received intravenous esmolol (n=157), while group B (n=162) did not receive it. Clinical characteristics, changes in heart rates, image quality and the mean effective radiation dose between two groups were compared in order to evaluate the application of intravenous esmolol in Double Flash. Results Heart rates at the beginning of scanning order in group A were significantly lower than group B (56.17±4.94 vs 61.22±3.79, P< 0.05). The score of Likert in image quality of group A were significantly higher than group B (3.29±0.36 vs 3.12±0.37, P< 0.05), while no significant difference was found in mean effective radiation dose between two groups (1.75±0.58 vs 1.86±0.69, P> 0.05). Conclusion For patients who receive Double Flash, the application of intravenous esmolol can effectively control their heart rates during the scanning and improve the image quality, which shows high value in clinical application.