Objective: To explore the application value of echocardiography combined with substraction technique in coronary stent visualization. Methods: A total of 120 patients with coronary stent implantation were randomized into control group (n=60, conventional ultrasound imaging examination) and test group (n=60, combination of substraction technique). The stent visualization clarity and diagnostic efficiency on in-stent restenosis were compared between the two groups. Results: The clarity degree of stent visualization in test group was significantly higher than that in control group (P<0.05). In diagnosing in-stent restenosis, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa value were 11.11% (2/18), 45.24% (19/42), 8.00% (2/25), 54.29% (19/35), 35.00% (21/60) and -0.393 of control group and were 85.71% (12/14), 65.22% (30/46), 42.86% (12/28), 93.75% (30/32), 70.00% (42/60) and 0.378 of test group respectively. The sensitivity, positive predictive value and accuracy in test group were significantly higher than those in control group (P<0.05). Conclusion: Echocardiography combined with substraction technique can significantly improve the image clarity of coronary stent, and thus enhance the accuracy of ultrasound diagnosis.