Aim To investigate the association between vascular endothelial growth factor (VEGF) and the severity of coronary lesions as well as coronary collateral development in patients with coronary heart disease. Methods The concentration of VEGF was measured by enzyme linked immunoserbent assay (ELISA) in 102 patients with angiographically documented coronary heart disease and 43 normal persons without any angiographically detectable coronary artery disease. The coronary artery score was recorded according to Leaman and the coronary collateral class was made according to Rentrop. The relationships between plasma VEGF and Leaman coronary artery score as well as coronary collateral circulation were assessed. Results The level of coronary artery plasma VEGF was obviously higher in the coronary disease group than in the control group (225±147 ng/L vs 74±52 ng/L ,p<0.01), and the mean VEGF was higher in coronary disease patients with collateral circulation than in patients without collateral circulation (299±152 ng/L vs 202±122 ng/L, p<0.01). The concentration of plasma VEGF was positively related to the Leaman score (r=0.693, p<0.001). Conclusions The plasma VEGF had correlation to both the severity of coronary stenosis and coronary collateral circulation in patients with coronary heart disease. VEGF might enhance collateral circulation development and doubly regulate the development of atherosclersis.