Objective To investigate the relationship between MCP-1-2518 G/A gene ploymorphisms and coronary heart disease (CHD). Methods The 360 patients were divided into three groups to undergo the coronary angiography (CAG): acute coronary syndrome (ACS) group (n=180), stable angina pectoris (SAP) group (n=120) and control group (n=60)). The severity and extent of coronary lesions was analyzed by CAG and typified by means of Gensini coronary score system. Enzyme-linked immunosorbent assay was used to measure the MCP-1 concentration. PCR-RFLP way was used to measure MCP-1-2518 G/A gene polymorphisms. Results MCP-1 gene polymorphisms GG gene and G allelic gene was significantly higher in ACS group compared with the SAP group and the control group[GG gene: ACS(33.4%), SAP(24.2%), control group(15.0%), P＜0.05; G allelic gene: ACS(51.1%), SAP(40.4%), control group(31.7%), P＜0.05],and was significantly lower in ACS group compared with the SAP group and the control group[AA gene: ACS(31.1%), SAP(43.3%), control group(51.7%), P＜0.05; A allelic gene: ACS(48.9%), SAP(59.6%), control group(68.3%), P＜0.05]. The MCP-1 concentration in GG gene group was significantly higher than that in AG gene group and AA gene group[GG gene: (153±22)ng/L,AG gene: (136±18)ng/L, AA gene: (124±15)ng/L, (P＜0.05)]. The Gensini score of coronary artery lesions was positively correlated with low density lipoprotein cholesterol, free blood glucose, MCP-1-2518 G/A GG gene polymorphisms (P＜0.05) and high density lipoprotein cholesterol was negatively correlated with stenotic degree of coronary artery.Conclusions MCP-1 gene ploymorphisms is positive regulators of coronary artery lesions. The G allelic of MCP-1-2518 G/A polymorphism can increase the MCP-1 expression than A allelic in cononary heart disease.