Aim To investigate the effects of rosuvastatin intensive lipid lowering therapy on plaque composition and structure of coronary borderline stenosis. Methods The patients with vessel diameter stenosis ratio between 50%～70% diagnosed by coronary angiography （CAG） were studied. Low density lipoprotein cholesterol （LDLC） was tested and lesion location was evaluated by virtual histology intravascular ultrasound （VH-IVUS）. Changes on plaque composition （such as lipid plaque, fibrous plaque, calcific plaque, mixed plaque and vulnerable plaque） and structure （such as plaque burden, minimal lumen area, and external elastic membrane area） were recorded. All patients with rosuvastatin 10～20 mg daily were assigned into intensive standard group （LDLC≤1.8 mmol/L） of 42 cases and control group （LDLC 1.9～2.6 mmol/L） of 41 cases . Keeping on taking rosuvastatin for one year, 80 patients completed the trial and repeated CAG and VH-IVUS assay at last. Results Compared with pre-treatment, lipid plaque content and vulnerable plaque decreased （P<0.05） after rosuvastatin therapy, while fibrous plaque and mixed plaque increased （P<0.05）. In addition, changes in intensive standard group were more obvious than the ones in control group （P<0.05）. As for plaque burden, it decreased after therapy in two groups （45%±6% vs 62%±7%, P<0.05 49%±6% vs 61%±7%, P<0.05）, while the decrease in intensive standard group was more significant than that in control group （45%±6% vs 49%±6%, P<0.05）. Minimal lumen area increased more in the intensive standard group than the control group. After therapy external elastic membrane area showed a slight decrease and positive remodeling alleviated. Conclusion Rosuvastatin intensive therapy could reduce lipid content in intermediate lesions, stabilize plaques and decrease plaque burden.