Objective To investigate the relationship between the plasma macrophage migration inhibitory factor (MIF) concentration and coronary arteriosclerosis lesions in patients with coronary heart diseases (CHD). Methods Totally 142 patients were divided into CHD group and control group according to the result of the coronary angiography (CAG). CHD group was further divided into stable angina pectoris (SAP) group and acute coronary syndrome (ACS) group according to the clinical diagnosis; and divided into one-vessel,two-vessel,three-vessel group according to the extent of coronary lesion. The plasma MIF concentration was measured by ELISA. Results The plasma MIF concentration was significantly higher in CHD group than in control group〔(14.97±4.11) vs (9.07±1.28) μg/L〕,and in ACS group than in SAP group〔(16.66±3.56) vs (11.01±2.12) μg/L〕. The plasma MIF concentration increased gradually with the increase of extent of coronary lesions. Conclusions The increase of plasma MIF concentration is significantly associated with development of coronary arteriosclerosis. MIF can be a reliable predictive index for coronary arteriosclerosis progression. MIF has a high association with unstable plaques in coronary arteriosclerosis.