Abstract: AIM: To compare the accuracy and limitations of 64-slice CT (MSCT) coronary angiography with invasive coronary angiography in the detection of significant coronary stenosis (≥50% lumen diameter narrowing). METHODS: Data were from 30 subjects ［21 males, 9 females, mean age (62±7) years, range: 49-74 years］ who had undergone MSCT and invasive coronary angiography within 2 weeks. Two experienced cardiologists analyzed the images of MSCT and invasive coronary angiography. RESULTS: For accuracy of coronary MSCT by each lesion segment, the average sensitivity was 50% and the average specificity 97%. Excluding the effect of 38 coronary segments with severe calcification, sensitivity and the specificity of MSCT were 74% and 99%, respectively. CONCLUSION: MSCT coronary angiography has a high accuracy rate and good potential for detection of coronary stenosis. However, severe calcification affects the accuracy in the detection of stenosis.