Aim To explore the relationship of microalbuminuria and the coronary artery stenosis degree in essential hypertension patients. Methods According to the results of urine protein quantitative in 24 hours, 82 patients in essential hypertension patients were selected as microalbuminuria (MAU) positive group and 82 microalbuminuria negative patients were selected as control group. The severity of coronary artery stenosis was compared. Results Compared to the microalbuminuria negative group [42/82 (52%)], the morbidity of coronary heart disease (CHD) were higher in microalbuminuria positive group [60/82 (74%)], with more prevalence in two vessels disease group (25% vs 12%, P<0.05); and three vessels disease group (15% vs 3%, P<0.05). Conclusion The incidence and severity of coronary heart disease were much higher in essential hypertension patients associated with microalbuminuria.