Objective To investigate the efficacy of different dose of atorvastatin in the elderly patients receiving coronary stent implantation. Methods A total of 237 elderly patients with coronary heart disease who underwent coronary stent implantation for the first time in our department from July 2014 to April 2015 were enrolled in this study. These patients were randomly assigned into intensive dose group (n=119,0 mg, once per day, for 12 months) and sequential dose group (n=118,0 mg, once per day, for 1 month, then 20 mg, once per day, for another 11 months). In 1 month after implantation, liver and kidney functions, blood lipids, blood glucose and other indicators were detected, then blood lipids test, echocardiography and coronary angiography were performed in 11 months later, and the incidences of major adverse cardiovascular events (MACEs) were recorded during follow-up. SPSS statistics 17.0 was used to perform the statistical analysis. Student’s t test and Chi-square test were employed for comparison of different data types between groups. Results In 1 and 12 months after implantation, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were significantly decreased in the both groups when compared with the baseline values (P<0.05). At the latter time point, the intensive dose group had obviously lower TG and LDL-C, but higher ejection fraction (EF) than the sequential dose group (P<0.05). During the follow-up period, there was no abnormal liver function, muscle pain, or freshly-diagnosed diabetes in the 2 groups, and no significant difference was found in the incidence of MACEs (P>0.05). Coronary angiography indicated that there was no difference in the occurrence of late lumen loss or restenosis between the 2 groups (P>0.05). Conclusion The efficacy of sequential dose of atorvastatin is similar as that of intensive dose in the elderly coronary stent implantation.