Aim To explore the effects of -477C/T single nucleotide polymorphism (SNP) in promoter region of ATP binding cassette transporter A1 (ABCA1) gene on plasma levels of high density lipoprotein cholesterol (HDLC) and its relationship with coronary heart disease (CHD). Methods -477C/T genotypes in promoter region of ABCA1 gene was detected in 124 CHD individuals and 111 healthy individuals by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and distribution of the -477C/T genotypes was compared between CHD group and healthy group, and also between different CHD clinical situations. The clinical indexes associated with CHD were also compared among the three genotypes. Results The higher proportion of the TT genotype and T allele was verified in CHD group than that in healthy group (p<0.05 and p<0.01). In CHD group, the higher proportion of the TT genotype and the T allele was further affirmed in ACS group than that in SAP group (p<0.01). The proportion of the TT genotype in multi lesions group was higher than that in single lesion group (p<0.05). The plasma levels of HDLC were differed significantly between the TT genotype and the CC genotype(p<0.001)in CHD group. Conclusions The plasma levels of HDLC may be influenced by the -477C/T SNP in the promoter region of ABCA1 gene in CHD group. The -477C/T SNP in the promoter region of ABCA1 gene may associate with the severity of coronary atherosclerosis and CHD.