This study was conducted in pursuit of the optimal imaging technique and for a primary clinical application of 16-slice multislice spiral computed tomography (MSCT) for coronary artery. Unenhanced and contrast-enhanced 16-slice SCT imaging was performed in 38 cases with retrospective electrocardiographic gating. MPR, MIP and VRT reconstruction of enhanced scan images were made in all cases, and CPR, VE reconstruction images were made in some cases. The demonstration of coronary artery was evaluated. The influencing factors of the image quality were analyzed. The results showed that the detection rates of RCA, PDA, LMA, LAD, DB, LCX and LMB were 36 (94.7%), 34 (89.5%), 37 (97.4%), 36 (94.7%), 34 (94.4%), 36 (94.7%), 34 (89.5%) on axial images, respectively, which were higher than those of the arteries on 3D images (P < 0.01). Therefore, 16-slice spiral CT is a reliable and accurate technique to demonstrate coronary artery and its branches, and is a noninvasive method to screen, diagnose and postoperatively evaluate coronary artery diseases. The factors influencing the image quality include the heart rate, the cardiac rhythm, the respiratory movement of patients and the trigger delays of imaging processing.