Objective To investigate the clinical characteristics of different plaques detected by intravascular ultrasound (IVUS). Methods From January 2010 to December 2013, 220 patients with coronary heart diseases confirmed by coronary angiography in our department were enrolled in this study. The patients were divided into 3 groups according to the ultrasound echo intensities of plaques in IVUS findings, that is, attenuated plaque group (n＝42), calcified plaque group (n＝63), and fibrous plaque group (n＝115). Their clinical baseline data and IVUS data were analyzed and compared. According to the results of IVUS findings, there were 140 case needing to undergo percutaneous coronary intervention (PCI), including 26, 41 and 73 cases respectively from the attenuated, calcified and fibrous plaque groups, with the ratio of PCI 62%, 65% and 63% in the three groups respectively. All were successful. The plaque types, PCI features and follow-up data were also analyzed in these 140 patients. Results The patients from the calcified plaque group had older age and lower levels of total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) when compared with those from the other groups (all P＜0.05). The attenuated plaque group had higher ratios in past histories of smoking, myocardial infarction, and coronary artery bypass surgery (CABG), and larger plaque burden and lesion vessel area when compared with the other 2 groups (all P＜0.05). Minimal lumen area and lesion vessel diameter were obviously smaller in the calcified plaque group than in the other 2 groups (all P＜0.05). For the 140 patients undergoing PCI, those from the attenuated plaque group had higher plaque burden than that from the other 2 groups (P＜0.05), and there were no significant differences in 1-year mortality, incidence of myocardial infarction and ratio of target vessel revascularization from the 3 groups (P＞0.05). Conclusion Past histories of smoking, myocardial infarction and CABG are correlated with the incidence of attenuated plaques. The patients with attenuated plaques have larger plaque burden than those with calcified or fibrous plaques. PCI has satisfactory therapentic effect on unstable plaques detected by IVUS.