Abstract: With the development of percutaneous coronary intervention, intravascular imaging has played an increasingly important role in the clinical diagnosis and treatment of coronary artery disease. Optical coherence tomography (OCT), is a new generation of intravascular imaging technology, and can provide higher resolution images and near microscopic details of plaques, stent restenosis and thrombus characteristics. OTC can better predict acute coronary syndrome and identify its etiology. At present, studies have shown that the optimization of PCI and evaluation of stent endothelialization and neointimal hyperplasia using OCT can improve and predict clinical prognosis. It is believed that with further development of OCT technology, its breadth and depth in the clinical diagnosis and treatment of coronary artery disease will be significantly increased and OTC will thus play an increasingly important role in the clinical diagnosis and treatment of coronary artery disease.