Objective To evaluate the application value of transthoracic echocardiography （TTE） and left ventricular opacification （LVO） in the diagnosis of coronary heart disease with ventricular aneurysm. Methods A total of 101 patients with coronary heart disease that had been confirmed by coronary angiography were included in this study. Comparison their ultrasound image characteristics and the detection rate of ventricular aneurysm by TTE and LVO. Results Twelve of 101 patients with coronary heart disease were determined with ventricular aneurysm by TTE, 7 in apex whose base width of ventricular aneurysms were （16.8±3.6）mm and 5 in the other part whose base width were （25.4±5.2）mm, the detection rate was 11.9%. 43 patients were determined with ventricular aneurysm by LVO，5 cases were multiple ventricular aneurysm，every of whom had 2 ventricular aneurysms. There were all 48 ventricular aneurysms，including 35 in apical ,whose base width of ventricular aneurysms were （11.7±1.1）mm, and 13 in the other part, whose base width were （14.3±6.1）. Compare the two methods of detection rate and the base width ,the differences had statistical significance(P＜0.05). The main features of ultrasound image of TEE：①Regional ventricle wall was thinned and aneurysmal bulged. The internal diameter of aneurysmal opening was larger than the diameter of aneurysmal body，and aneurysmal wall was connected to ventricular wall. ②Aneurysmal wall showed no movement or paradoxical movement during systole，and mural thrombus was found in some aneurysms. The main features of ultrasound image of LVO：Contrast agent was filled in left ventricular，which made left ventricular endocardial border more clearly identified. Regional ventricle wall was thinned and aneurysmal bulged. Aneurysm was filled with contrast agent，which showed reverse movement or decreased movement during systole. Aneurysmal wall of functional ventricular aneurysm could restore to normal morphology during diastole，while aneurysmal wall of anatomical aneurysm bulged during systolic and diastolic. Conclusion TTE and LVO both can detect ventricular aneurysm in noninvasive. The diagnosis of ventricular aneurysm in apical and tiny aneurysm by LVO is superior to TTE. LVO could show the fine anatomical structure of ventricular wall clearly，and dynamically show the motion state of ventricular aneurysm during systolic and diastolic，which is beneficial to distinguish functional ventricular aneurysm and anatomical ventricular aneurysm.