Abstract: Objective To explore the clinical value of multi-slice spiral computed tomography in the diagnosis of coronary heart disease (CHD) in pilots. Methods Twenty nine pilots with suspected CHD in our hospital underwent multi-slice spiral computed tomography (MSCT) and the coronary angiography (CAG).The sensitivity, speci ficity, positive predictive value (PPV) and negative predictive value (NPV) of MSCT in the diagnosis of coronary artery stenosis were analyzed and compared with CAG results. Results All pilots received MSCT and CAG. MSCT showed normal coronary artery in 5 cases, myocardial bridge in 5 cases and coronary artery stenosis at different level in 19 cases with one case complicated by myocardial bridge. Meanwhile, MSCT showed 20 segments of mild stenosis, 9 segments of moderate stenosis and 5 segments of severe stenosis in 29 pilots. Comparing to CAG results, the sensitivity, specificity, PPV and NPV of MSCT in the diagnosis of coronary artery stenosis and segment stenosis were 73.7%, 99.5%, 93.3%, 97.4% and 79.2%, 95.7%, 82.6%, 94.6%, respectively. Conclusion MSCT is a noninvasive method for the diagnosis of CHD. The plaque on the vessel wall and the stenosis of coronary artery can be accurately detected by MSCT, which has a high clinical value in the diagnosis of CHD in pilots.