Abstract: AIM To investigate the efficacy of fasudil in the treatment of coronary slow flow (CSF) and its effect on plasma oxidative stress indexes: MDA, AGEs, SOD and GST. METHODS Eighty-two CSF patients with normal coronary angiography were randomly divided into conventional treatment group and fasudil group, 41 cases ineach group. Another 40 patients with normal coronary angiography served as control group. Patients in the conventional treatment group were given conventional treatment (aspirin, nitrates and simvastatin), while patients in the fasudil group were given fasudil on the basis of the conventional treatment. Angina pectoris, TIMI and levels of plasma MDA, AGEs, SOD and GST of the brachial artery were observed in the three groups before and two weeks after treatment. RESULTS The total effective rate in the fasudil group was higher than that in the control group (88% vs. 66%, P<0.05). TIMI improved significantly in the fasudil group after treatment compared with that before treatment and with that in the conventional group after treatment (P<0.01). The peripheral blood levels of MDA and AGEs in the CSF group at the beginning of treatment were significantly higher than those in the normal control group (P<0.01). The peripheral blood levels of SOD and GST in CSF group at the beginning of treatment were significantly reduced compared with those in the normal control group (P<0.01). The peripheral blood levels of MDA and AGEs in the fasudil treatment group and conventional therapy group were all significantly reduced compared with those in the normal control group (P<0.01). The peripheral blood levels of SOD and GST in the fasudil treatment group and conventional therapy group were all significantly higher than those in the normal control group (P<0.01). No difference in pre-treatment MDA, AGEs, SOD and GST were found between the two groups (P>0.05). The pre-treatment MDA and AGEs levels in fasudil treatment group were significantly reduced compared with those in the conventional therapy group (P<0.01). The pre-treatment SOD and GST levels in the fasudil treatment group were significantly higher than those in the conventional therapy group (P<0.01). CONCLUSION Oxidative stress may play a key role in the pathophysiology of CSF. Fasudil improves the curative effect of coronary slow flow by inhibiting oxidative stress.