Aim To explore the providing leads of coronary artery collateral vessels in patients with coronary atherosclerotic heart disease on predicting prognosis and guiding treatment.Methods 68 patients with total occlusion of coro-nary arteries through coronary arteriograph were divid-ed into good development of collateral vessels group and poor development of collateral vessels group.Compared their ECG ST-T changes,motion stress testing.QRS scores,ventricular wall motion scores,ejection fraction,left ventricular end diastolic pressure and cardiac index between the two groups.Results Compared with the poor development of collateral vessels group,in the good development of collateral vessels group the ECG ST-T changes and left ventricular end diastolic pressure were obvious less(P <0.01),QRS scores and ventricular wall motion scores were lower(P<0.01),ejection fraction and cardiac index were higher(P<0.01),their positive rate of motion stress testing was not significant differ-ence(P<0.05).myocardium has not infarcted in 4patients of the good development of collateral vessels group,treadmill stress testing was negative in three of four cases.Conclusion Observing collateral vessels during coronary arteriograph can provide valuable leads in pa-tients with coronary atherosclerotic heart disease on predicting prognosis and guiding treatment.