Objective: To explore the diagnostic value of combined examination of cardiac color Doppler ultrasound and carotid artery ultrasound in elderly patients with coronary heart disease. Methods: The clinical data of 78 elderly patients with highly suspected coronary heart disease who visited our hospital from January 2021 to August 2024 were retrospectively collected. All patients underwent cardiac color Doppler ultrasound, carotid artery ultrasound examination and coronary angiography respectively. The results of coronary angiography were taken as the "gold standard" for diagnosing coronary heart disease, and the consistency of the results of cardiac color Doppler ultrasound, carotid artery ultrasound examination and coronary angiography was analyzed. To analyze the diagnostic value of combined examination of cardiac color Doppler ultrasound and carotid artery ultrasound for coronary heart disease in the elderly. Result: Confirmed by coronary angiography, among 78 highly suspected elderly patients with coronary heart disease, 60 cases were positive and were included in the coronary heart disease group. Eighteen negative cases were included in the non-coronary heart disease group. The ejection fraction in the coronary heart disease group was significantly lower than that in the non-coronary heart disease group, while the left ventricular end-diastolic diameter, left ventricular end-systolic diameter, carotid intimal thickness and plaque score were significantly higher than those in the non-coronary heart disease group (P < 0.05). The receiver operating characteristic (ROC) curve was plotted. The results showed that ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, Tei index, carotid intimal thickness, and plaque score all had certain diagnostic value for coronary heart disease, and the area under the curve (AUC) was all > 0.70. The consistency between the results of cardiac color Doppler ultrasound combined with carotid artery ultrasound in the diagnosis of coronary heart disease in the elderly and the results of coronary angiography was average (Kappa=0.681, 0.704). The results of the combined diagnosis of coronary heart disease in the elderly were in good consistency with the results of coronary angiography (Kappa=0.928). The accuracy of cardiac color Doppler ultrasound combined with carotid artery ultrasound in diagnosing coronary heart disease was significantly higher than that of the two alone (P < 0.05). Conclusion: The combined examination of cardiac color Doppler ultrasound and carotid artery ultrasound can improve the diagnostic accuracy of coronary heart disease in the elderly and has good consistency with the diagnostic results of coronary angiography.