objective: to explore the application effect of multi-slice spiral CT coronary angiography in the diagnosis of cardiac vascular stenosis.Methods: From January 2022 to December 2024, 125 patients with suspected cardiovascular diseases in Xuchang Central Hospital were selected to participate in the study, and all of them were diagnosed by multi-slice spiral CT coronary angiography. The gold standard diagnosis was digital subtraction angiography, and the diagnosis results were analyzed.Results: Among 125 patients suspected of cardiovascular disease, 82 cases were positive according to the gold standard diagnosis. 43 cases were negative. Multi-slice spiral CT coronary angiography: 79 cases were positive; 46 cases were negative. Diagnostic efficiency of multi-slice spiral CT coronary angiography: accuracy 96.00%, specificity 97.67%, sensitivity 95.12%. Right stenosis was 32.00%, left stenosis was 31.20%, and no stenosis was 36.80%. Among them, there were 6 cases of slight stenosis; 59 cases of mild stenosis; Moderate stenosis in 28 cases; Severe stenosis in 6 cases.Conclusion: Multi-slice spiral CT coronary angiography is effective in the diagnosis of cardiac vascular stenosis, which can effectively detect the stenosis of patients and facilitate the follow-up treatment. It is a noninvasive and reliable invasive method with significant application value.