ObjectiveTo Summarize the features and diagnostic thinking of anomalous origin of left coronary artery from pulmonary artery（ALCAPA） with transthoracic echocardiography（TTE）.MethodsThe clinical and imaging features of 8 ALCAPA patients confirmed by surgery in our hospital were retrospectively analyzed,and the characteristics of TTE were summarized.ResultsAmong the 8 cases of ALCAPA，the left ventricular systolic function was all normal, 1 case was infant type with pneumonia，ST changes and enlarged heart shadow in the early stage.7 cases were adult type with no obvious symptoms，and the heart murmur was found in the first visit.Only 1 case was first diagnosed by ultrasound，6 cases were diagnosed after re-examination by senior doctors，1 case was misdiagnosed as coronary pulmonary artery fistula. Typical TTE characteristics of ALCAPA: enlarged left ventricle，widened right coronary artery，abundant collateral blood flow，abnormal blood flow signal in pulmonary artery.Conclusion Bothinfants with heart failure and ST changes and enlarged heart shadows and children or adults with abundant collateral blood flow and widened right coronary arteries all need to be alert to ALCAPA.Careful scanning of the origin and blood flow direction of the left coronary artery（LCA） can help improve the early diagnosis of ALCAPA by TTE.