Objective To compare ECG and coronary CTA in the diagnosis of coronary heart disease among people of physical checkup.Methods A total of 3186 subjects were selected as the research objects from 3293 physical examinees in our health medical center in May 2021,excluding 97 subjects who did not receive coronary CTA and 10 subjects who did not implement ECG. Descriptive statistics and grouping chi square were used to analyze the physical examination Results.Results A total of 237 cases of coronary heart disease were found with the judgement of coronary stenosis. The abnormal electrocardiographic manifestations were as follows: 750 cases of ST-T segment change, 137 cases of left deviation of ECG axis, 83 cases of left ventricular high voltage, 42 cases of complete right bundle branch block and 41 cases of incomplete right bundle branch block. There was statistical difference in ECG between patients with coronary heart disease (33.3%)and patients without coronary heart disease (22.8%)(χ²=13.642,P＜0.05).Conclusions ECG which is simple and convenient can help to distinguish coronary heart disease in large-scale physical examination population with other check programs.