Abstract: AIM To study the clinical value of intravascular ultrasound(IVUS) in diagnosis and treatment of intermediate lesions in airline pilots with coronary intermediate stenosis. METHODS The parameters of 165 coronary intermediate stenoses in 120 patients including minimum lumen diameter(MLD), diameter stenosis(DS), minimum lumen area(MLA) and area stenosis(AS) were evaluated and compared, respectively, by quantitative coronary angiography(QCA) and IVUS. Stent implantation was performed on patients with MLA <4 mm² calculated by IVUS. RESULTS MLD, MLA, AS and DS by QCA were significantly lower than those by IVUS(P<0.01), indicating IVUS was more accurate in evaluating intermediate coronary stenosis. IVUS enhanced the diagnosis rates of thrombus(15.0% vs. 2.5%, P=0.05) and myocardial bridging(42.50% vs. 2.5%, P<0.01). IVUS was superior to QCA in showing stent placement and deployment. CONCLUSION In the diagnosis and treatment of intermediate stenosis, IVUS is superior in detecting the severity of intermediate stenosis, diagnosing thrombus and myocardial bridging and optimizing safer clinical treatment strategies.