Objective To investigate the diagnosis accuracy of chest pain characteristics for coronary artery disease. Methods All the consecutive inpatients (n=240) with chest pain undergoing coronary angiography (CAG) and coronary fractional flow reserve (FFR) determination in First Medical Center, Chinese PLA General Hospital, during June 2012 to June 2016 were enrolled in this study. According to their medical history, they were divided into non-chest-pain group (n=55), atypical chest pain group (n=79), typical effort angina group (n=64) and coronary stent implantation group (n=42). The correlations of different chest pains with the results of CAG and FFR were analyzed. SPSS statistics 19.0 was used to perform the statistical analysis. According to different data type, analysis of variance or χ² test was used for comparison. Results The results of CAG indicated that the average stenosis was (70.82±13.39)%, (69.62±9.96)%, (73.52±12.87)%, and (67.98±14.27)%, respectively in the non-chest-pain group, atypical chest pain group, typical effort angina group and coronary stent implantation group (P>0.05). And their FFR value was (0.84±0.08) , (0.84±0.08), (0.79±0.11) and (0.82±0.08), respectively (P<0.05). Significant difference was seen between the atypical and typical chest pain groups (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the accuracy of predicting FFR with CAG identified stenosis was quite high, and CAG identified 72.00% stenosis had an area under ROC of 0.854 and a Youden index of 0.60, asensitivity of 87% and a specificity of 73%. Conclusion Typical chest pain has a quite high accuracy in the diagnosis of myocardial ischemia of coronary artery disease. Typical angina, coronary stenosis >80.00%, FFR<0.80 can be used as a reference for revascularization treatment.