Aim Based on coronary artery CT angiography data, to establish the finite element model of coronary artery with different degrees of stenosis and to study the simulative hemodynamics; To analyze the change of wall shear stress (WSS) and its key role in atherosclerosis. Methods Using the data of coronary artery CT angiography in patients with coronary artery stenosis, a three-dimensional model of precise anatomy was established. The finite element software was used to establish the finite element model, and various boundary conditions were set up for simulation analysis. At last the calculation and analysis were performed, and the results were obtained in the form of a graph. Results The WSS of coronary artery was increased significantly at stenosis place, and gradually increased with the increase of the degree of vascular stenosis. The WSS was decreased at the area behind stenosis, and was reverse proportional to the degree of coronary artery stenosis. There was a shear stress gradient between the two, and gradually increased with the increase of vascular stenosis degree. Conclusion The changes of WSS can lead to the development of atherosclerotic plaques and play an important role in the pathogenesis of atherosclerosis.