Abstract: AIM To compare the lesion characteristics measured by intravascular ultrasound (IVUS) in different types of syndrome by traditional Chinese medicine in patients of coronary artery diseases. METHODS Twendty-eight consecutive patients of coronary artery disease confirmed by IVUS was made the differential diagnosis as blood stasis group (n=10) and endogenous collateral wind group (n=18). The indexes such as area of plaques in criminal lesions, the area of extra-elasticity membrane (EEM), plaque burden, the incidence of high-risk plaques, the positive or negative remodeling percentage and remodeling index (RI) were measured by IVUS. Analyses were performed by statistical package SPSS11.0. RESULTS The area of plaques in criminal lesions, the area of EEM and plaque burden in endogenous collateral wind group were significantly larger than those in blood stasis group (P<0.01, P<0.01, P<0.05, respectively). The incidence of high-risk plaques and RI in endogenous collateral wind group were markedly higher than those in blood stasis group (P<0.05, P<0.05, respectively). More positive remodeling was observed in endogenous collateral wind group (P<0.05) whild the more negative remodeling was seen in blood stasis group (P<0.05). CONCLUSION The coronary arterial atherosclerotic plaques in the patients with endogenous collateral wind may be more unstable.