Aim To investigate the correlation between non-high density lipoprotein cholesterol level and severity coronary heart disease(CHD). Methods 522 cases of coronary angiography were retrospectively analyzed, according to the results of coronary angiography combined with clinical features, electrocardiogram and myocardial enzyme, which were divided into non-CHD group, angina pectoris group, myocardial infarction group. The average age is 60.00±10.02 years. Gensini score was used to evaluate the degree of coronary artery lesions in patients with coronary heart disease, the clinical data of all patients were collected, and the serum lipid levels were measured and non-high density lipoprotein cholesterol was calculated. The correlation between non-high density lipoprotein cholesterol and coronary heart disease was analyzed. Results Gensini levels had statistically significant differences in the three groups (P<0.05); In angina pectoris group, non-high density lipoprotein cholesterol level and Gensini score are positively correlated (r=0.130, P=0.022); In myocardial infarction group, non-high density lipoprotein cholesterol level and Gensini score are positively correlated (r=0.213, P=0.048); Logistic regression analysis showed that age, gender and non high density lipoprotein cholesterol level were risk factors for coronary heart disease (P<0.05). Conclusion Non-high density lipoprotein cholesterol is an important index to reflect the condition of patients with coronary heart disease.