Abstract: AIM To observe the clinical effect of nicorandil on patients with cardiac syndrome X and to analyze the treatment results. METHODS Forty-five patients diagnosed with cardiac syndrome X between January 2013 and December 2013 in our hospital were enrolled and randomly divided into nicorandil group( n = 23) and control group( n = 22). Patients in the two groups were given routine drug treatment and,in addition,nicorandil 5 mg tid orally per day was given in nicorandil group. After a 3-month follow-up,chest pain was examined and treadmill exercise test was conducted. RESULTS Angina pectoris was reduced in both control group ( 29. 8 ± 5. 5) Times / month vs.( 20. 4 ± 4. 5) Times / month,P < 0. 05 and nicorandil group ( 31. 7 ± 3. 4) Times / month vs.( 19. 5 ± 5. 1) Times / month,P < 0. 05with better results in nicorandil group. Total duration of exercise,maximal ST segment depression,and occurrence of angina in exercise test were improved in both groups,with better results in nicorandil group. CONCLUSION: Based on the basic treatment,nicorandil can further improve the symptoms of angina pectoris in patients with cardiac syndrome X.