Aim To investigate the efficacy and Safety of simvastatin on patients with coronary heart disease.Methods The study was a random,open,two-dose control trail to evaluate simvastatin administering (10,20 mg/d) to 102 patients with myocardial infarction or angina, whose total cholesterol (TC) was over 2.68 mmol/L and low density lipoprotein cholesterol (LDLC) was over 2.6 mmol/L. Lipid level was determined after 90 and 180 d. Results The blood concentrations of TC and LDLC were significantly decrease after treating withlO and 20 mg simvastatin 90 d and 180 d (P< 0.05)and the curative effect of 20 mg group was more evident than that of 10 mg group (P< 0.05). The TC target rates of 10 mg and 20 mg after 180 d were 21% and 40% and the LDLC target rates of 10 mg and 20 mg after 180 d were 25% and 44% ( P< 0.05). The level of high density lipoprotein cholesterol was gradually increased; the triglyceride was decreased during the following-up, but there were no significant different. The adverse reaction of simvastatin was mild and relatively rate. Conclusion The results suggested that 10 mg or 20 mg of simvastatin could markedly decrease TC and LDLC concentration and was safety and feasible; the effect of 20 mg-group is superior to 10 mg-group.