Aim To evaluate the diagnostic value of ST segment depression limited to the recovery phase of exercise stress testing for coronary artery disease. Methods 168 patients from July 2008 to December 2012 were selected for the study. They received both exercise stress testing and selective coronary angiography. According to the results of exercise test, patients were allocated into exercise-phase ST depression group （exercise group, n＝90）, 54 male and 36 female, age between 35～80, recovery-phase ST depression group （recovery group, n＝61）, 26 male and 35 female, age between 45～74, and negative exercise test group （negative test group, n＝17）, 11 male and 6 female, age between 35～80. Based on results of coronary angiography, they were categorized into marked stenosis group, slightly stenosis group and angiographical normal group. Clinical characteristics of three groups, relations between stress test and coronary angiography, and echocardiographic parameters were compared. Results The patients in exercise-phase ST depression group were older and there were more diabetes in this group. The high density lipoprotein cholesterol （HDLC） level was lower, and the creatine and cystatin C levels were higher than other two groups （P<0.05）. There were more exercise-phase ST depression in marked stenosis group than other two groups （P＜0.05）. Recovery phase ST depression group showed higher percentage of slight stenosis compared with exercise-phase group （P<0.01）. Exercise-phase ST depres sion was more sensitive to find out one, two or three vessels lesions than recovery phase ST depression. Echocardiographic left ventricular end diatolic volume was lower than other two groups （P<0.05）. Conclusions Patients with recovery-phase ST depression had less coronary risk factors and more slight stenosis in coronary arteries. Diagnosis of coronary artery disease in recovery-phase ST depression patients should be individualized and considered based on risk factors assessment.