Abstract: AIM To observe the prognostic impact of interventional therapy guided by intravascular ultrasound (IVUS) on patients with intermediate coronary lesions of fractional flow reserve threshold value. METHODS Patients with intermediate coronary lesions of fractional flow reserve threshold value were randomly divided into IVUS guided treatment group (IVUS group) and drug treatment group. The IVUS group was further divided into a PCI guidance IVUS group (IVUS-PCI group) and an IVUS guidance drug treatment group (IVUS-drug group). All patients were followed up for six months and the incidence of major adverse cardiovascular events (MACE) was compared between the groups. RESULTS The incidence of MACE in IVUS group was significantly lower than that in drug treatment group, but there was no significant difference in the incidence of MACE between IVUS-PCI group and IVUS-drug group. CONCLUSION The prognostic impact of interventional therapy guided by IVUS on patients with intermediate coronary lesions of fractional flow reserve threshold value is superior to that in patients treated only with drugs without IVUS measurement.