Aim To investigate the changes of the positive rate of full-length membrane-enchored T cell immunoglobulin and mucin-domain containing molecule family-3 (flTim-3) on CD14＋ monocyte in peripheral blood and the levels of serum soluble Tim-3 (sTim-3), tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in patients with coronary heart disease (CHD) and their clinical significance. Methods 196 suspected CHD patients were selected as the study subjects, and all the selected patients underwent coronary angiography. According to the results of coronary angiography and CHD diagnostic criteria, the selected patients were divided into non-CHD group (n＝54), stable angina pectoris (SAP) group (n＝87) and acute coronary syndrome (ACS) group (n＝55). General information was recorded. The positive rate of flTim-3 in peripheral blood monocytes was determined by flow cytometry. The concentrations of serum sTim-3, TNF-α and IL-6 were measured by enzyme-linked immunosorbent assay. Results Compared with non-CHD group, flTim-3 positive rate, TNF-α, IL-6 concentrations in SAP group and ACS group were higher, and ACS group was higher more, the difference was statistically significant (P＜0.05); While sTim-3 concentration was lower, ACS group was lower more, the difference was statistically significant (P＜0.05). Pearson correlation analysis showed that flTim-3 was positively correlated with TNF-α and IL-6, while sTim-3 was negatively correlated with TNF-α and IL-6 (P＜0.01). Logistic regression analysis showed that flTim-3, sTim-3, TNF-α, IL-6 were correlated with the clinical phenotype of CHD (P＜0.05). Conclusion FlTim-3 and sTim-3 affect the clinical phenotype of CHD by regulating the expression of monocyte/macrophage inflammatory factors. FlTim-3 and sTim-3 have predictive value for the clinical phenotype of CHD.