Objective To investigate the relationship of serum uric acid（UA） and endothelial dysfunction in elderly coronary heart disease patients. Methods In this prospective cohort study, the relationship of UA and endothelial dysfunction was investigated in 78 elderly coronary heart disease patients and 78 healthy patients. The clinical and laboratory data of blood UA, blood lipids and hs - CRP were collected. Patients′ blood pressure and  body mass index(BMI) were tested and recorded at the same time. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter. Finally, we compared the difference between each group and analyzed the results with statistical methods. Results UA levels differed between 78 elderly coronary heart disease patients and 78 healthy patients［(408.6±116.0)μmol/L vs.(327.5±92.8)μmol/L，P=0.007］. There were significant linear correlations between UA and FMD, hs-CRP, (all P＜0.01). There were no obvious correlations between FMD and age, BMI blood pressure, total cholesterol. Multivariate regression analysis showed that only UA was an independent determinant of FMD (β=-0.237, P=0.036). Conclusion There exists an independent correlation between UA and FMD, and higher UA level is related to worse endothelial function which may contribute to cardiovascular morbidity.