[Abstract] Objective To study the ultrasound diagnosis and differential diagnosisthe of anomalous origin of the left coronary artery from the pulmonary. Methods To retrospective analysis of the diagnosis and misdiagnosis of 21 patients with left coronary artery abnormality in our hospital.Results 21 patients with left coronary artery abnormality originated from pulmonary artery, 17 first ultrasound diagnosis, 3 misdiagnosis, one missed diagnosis, and 19.0% of misdiagnosis rate. Conclusion Color Doppler ultrasound is the preferred examination method of left coronary artery abnormality, with high clinical value, but the differential diagnosis cannot be ignored.