Abstract: AIM: To investigate depression and changes of tumor necrosis factor alpha (TNF-α) level in elderly patients with coronary heart disease (CHD) and the impact of depression on TNF-α. METHODS: A total of 214 cases with stable angina were included in our study. According to diagnostic criteria from the Chinese Classification of Mental Disorders, the third edition (CCMD-3), the patients were divided into two groups: CHD group and depression (n=54) and CHD group without depression (n=160). Fifty healthy subjects were randomly used as control group. Biochemical indexes, ZUNG self-rating depression scale scores and TNF values were measured and the differences of TNF in different groups and the relationship between tumor necrosis factor-α (TNF-α) and depression scores were explored. RESULTS: TNF level in CHD group with depression was significantly higher than that in CHD group without depression (P<0.05). TNF and depression scores were positively correlated (r=0.424, P<0.01). After controlling WBC and C-reactive protein, TNF and depression scores remained positively correlated (r=0.344, P=0.000). CONCLUSION: The level of tumor necrosis factor increases in elderly CHD patients with depression.