Aim To study the relationgship and the clinical significance between plasma fibrinogen and fractional flow reserve (FFR) in coronary intermediate lesions. Methods The patients were from Department of Cardiovascular of Affiliated Hospital of Xuzhou Medical College. Their coronary artery lesions were assessed by CAG from February 2013 to November 2015, the degree of coronary artery stenosis ranged from 50% to 70%. According to the FFR, the patients were divided into two groups:the FFR≥0.8 group (n＝23) and the FFR＜0.8 group (n＝14). Plasma fibrinogen, total cholesterol, triglyceride, uric acid and blood glucose were detected. After controlling the influencing factors of fibrinogen and coronary artery lesions, the correlation between firinogen and FFR was analyzed by correlation analysis and ROC curve.Results Partial correlation analysis showed that fibrinogen was negatively correlated with FFR (r＝－0.477, P＜0.01). The levels of fibrinogen in the FFR＜0.8 group were higher than those in the FFR≥0.8 group (3.50±0.72 g/L vs. 2.68±0.63 g/L, P＜0.05). ROC analysis showed that the best cutoff vlaue was 2.692 g/L with the biggest sum of sensitivity and specificity (0.929 and 0.652, respectively), when FFR＝0.8 as a boundary. Conclusions Plasma fibrinogen can be used to detect myocardial ischemia in coronary intermediate lesions, it is associated with the degree of myocardial ischemia in coronary intermediate disease and can be used as a predictor of myocardial ischemia and stent implantation in coronary intermediate disease.