Objective To analyze the reasons associated with ticagrelor withdrawal and the impact on clinical outcomes in ticagrelor-treated patients with coronary artery disease (CAD). Methods Totally 642 consecutive CAD patients treated by ticagrelor and aspirin in the Department of Cardiology, Chinese PLA General Hospital from January 2014 to July 2015 were recruited. The incidence and the reasons of ticagrelor withdrawal were recorded and analyzed during the hospitalization, at discharge, as well as 3-month after discharge. In the patients treated by percutaneous coronary intervention (PCI), the occurrence of ischemic events [including major ischemic events (cardiovascular death, non-fatal myocardial infarction, ischemic stroke, defined or probable stent thrombosis, coronary revascularization) and secondary ischemic events (readmission of unstable angina)] and bleeding events [including Thrombolysis In Myocardial Infarction trial (TIMI) defined major and minor bleedings] were followed up for 6 months. Results Ticagrelor withdrawal occurred in 164 patients (25.55%), with 42 patients (25.61%) in-hospital, 7 patients(4.27%) at discharge and 115 patients (70.12%) after discharge, respectively. The distributions of ticagrelor withdrawal were 78.05% in unstable angina, 13.41% in ST-elevation myocardial infarction (STEMI), 4.27% in non-STEMI, 4.27% in stable CAD, respectively. The reasons for ticagrelor withdrawal in-hospital and at discharge were mainly attributed to ticagrelor-related dyspnea (32.65%), bleeding (22.45%) and PCI for non-complex coronary lesions (18.37%). Drug unavailability (68.70%) and cost consideration (16.52%) were the major reasons for ticagrelor withdrawal after discharge. Besides 10 dead patients, other patients with ticagrelor withdrawal undertook the alteration of the antiplatelet therapy under the guidance of physicians, with 153 switched to clopidogrel on top of aspirin treatment, 1 to aspirin alone. After 6-month follow-up in PCI patients (n＝499), compared with patients under continuous ticagrelor treatment, patients withdrawing ticagrelor had a higher risk of major ischemic events (4.58% vs 0.82%, HR 6.62, 95%CI 1.17?37.36, P＝0.032) and composited ischemic events (11.45% vs 4.89%, HR 2.46, and 95%CI 1.03?5.89, P＝0.043). No significant difference was found for the risk of composited bleeding events between these patients (16.03% vs 17.12%, HR 0.92, and 95%CI, 0.49?1.73, P＝0.795). Conclusion About one third of ticagrelor treated CAD patients undertake the ticagrelor withdrawal during hospitalization, discharge and within 3 months after hospitalization. Ticagrelor withdrawal in-hospital and at-discharge might be attributed mainly to ticagrelor-related dyspnea, bleeding and non-complex lesions for PCI. Drug unavailability and cost consideration might be the main reasons for out-hospital ticagrelor withdrawal. Ticagrelor withdrawal within 3-months in PCI treated CAD patients might be correlated with increased risk of major and composited ischemic events.