Objective To observe the incidence of acute lower respiratory tract infection and its influence on cardiovascular events in the elderly patients with stable coronary heart disease. Methods The study enrolled 168 elderly patients with stable coronary heart disease who were treated in Panzhihua Central Hospital from February 2015 to February 2017. The patients were divided into infection group and non-infection group according to occurrence of acute lower respiratory tract infection. The two groups were compared in the white blood cell count (WBC), red blood cell distribution width (RDW), platelet distribution width (PDW) level, and serum brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and other clinical data. During the follow-up of 6 months, the two groups were observed for the incidence of cardiovascular events and compared in clinical pulmonary infection scale (CPIS). Data processing was performed using SPSS statistics 17.0. Depending on the data type, Student′s t test or Chi-square test was performed for comparison between groups. Results Among 168 patients, 68(40.48%) were complicated with lower respiratory tract infection. The infection group were significantly higher than the non-infection group in WBC [(9.87±0.95)×10⁹/L vs (6.42±0.84)×10⁹/L] and RDW [(13.92±0.98)% vs (13.05±1.02)%], PDW [(11.78±1.02)% vs (11.01±0.94)%] and BNP [(852.68±9.35) vs (215.71±10.04)pg/ml] but significantly lower in LVEF [(56.49±7.82)% vs(60.02±6.18)%] (P< 0.001). The incidence of cardiovascular events was significantly higher in the infection group than in the non-infection group [36.76%(25/68) vs 5.00%(5/100),P<0.001]. CPIS scores were significantly higher in the patients with cardiovascular events than those without [(1.58±0.23) vs (1.01±0.19), P<0.001]. Conclusion The incidence of acute lower respiratory tract infection is high in elderly patients with stable coronary heart disease, and cardiovascular events are more likely to occur in the patients complicated with lower respiratory tract infection, suggesting that attention should be paid to the prevention of respiratory tract infection in patients with coronary heart disease.