Abstract: Objective To improve the diagnosis and treatment of trilogy of the acute coronary syndrome,renal artery stenosis and acute left heart failure. Methods Clinical data about 25 patients with the trilogy of the acute coronary syndrome,renal artery stenosis and acute left heart failure admitted to our hospital as well as the relation between baseline data and prognosis were retrospectively analyzed. Results The incidence of hypertension and old myocardial infarction,hyperlipidemia,diabetes mellitus,and peripheral angiopathy was 100%,54.0%,60.0%,40.0%,48.0%,and 36%,respectively,in the patients.The average period of time from the onset of angina pectoris to the final diagnosis of coronary heart disease（by angiography or computerized tomography or old MI） and renal artery stenosis（by angiography） was 5.3 years and 11.5 years respectively,while the average period of time for the verification of coronary heart disease and renal artery stenosis was 6.2 years.Thirteen patients were diagnosed with stenosis of bilateral renal artery and severe stenosis of 2.6 coronary arteries（area stenosis＞70%） in all patients.Coronary artery and/or renal artery intervention or coronary bypass was performed for all patients.Of the 25 patients,2 died due to the failure of treatment,23 were discharged from hospital after recovery.However,the renal function of 3 out of the 23 patients was worse at the time of discharge than at the time of admission.During the 2-year follow-up,12 patients were improved and their disease became stable,4 patients died,7 patients had secondary endpoint events.No baseline data were found to be related to the prognosis due to a small sample size and selection bias. Conclusion The prognosis of patients with trilogy of acute coronary syndrome,renal artery stenosis and acute left heart failure is poor 2 years after operation.Early diagnosis and treatment of the disease can decrease its incidence and improve its prognosis.