Abstract: Objective: to analyze and optimize the application value of 128 slice spiral CT scanning in chest pain triad. Methods: 69 patients with highly suspected chest pain triad were examined by 128 slice spiral CTA, and all the original data were reconstructed with a variety of post-processing techniques such as maximum density projection (MIP), surface reconstruction (CPR), volume rendering (VR), and multiplane reconstruction (MPR).The methods were performed on the thoracic aorta and coronary artery respectively. The arteries and pulmonary arteries were analyzed at different angles. Results: the main branches of the thoracic aorta and bilateral pulmonary arteries (CT value of 200 HU) were clearly shown in 69 patients with acute chest pain, and the image quality of the coronary artery was superior to 63.7% (44/69), 30.4% (21/69) and 5.8% (4/69). Conclusion: the specificity of the 128 slice spiral CTA triple scan CTA examination in the diagnosis of coronary syndrome is 94.7% (36/38), the accuracy is 95.8% (69/72). The specificity and accuracy of the diagnosis of the pulmonary artery and the aortic disease is very high. Through this study, we can preliminarily conclude that 128 slice spiral CT triple scanning has important application value in the triplet of chest pain.