Objective：To assess the value of MRI and single photon emission computed tomography (SPECT) in detecting myocardial ischemia and necrosis. Methods: Coronary angiography (CAG), MRI and SPECT were performed in 28 patients with coronary artery disease one week before revascularization operation. The stenosis criterion was a more than 70% stenosis by CAG; the sensitivity，specificity and accuracy of both MRI and SPECT were calculated according to the criterion. Results: CAG revealed 39 positive arteries and 45 negative arteries. According to the CAG results, the sensitivity, specificity and accuracy of MRI for detecting myocardial ischemia were 92.31%, 80.00% and 85.71%, respectively; and for detecting myocardial necrosis were 66.67%, 91.11%, and 79.76%, respectively. The sensitivity, specificity and accuracy of SPECT for detecting myocardial ischemia were 94.87%, 82.22% and 88.10%, respectively; and for detecting myocardial necrosis were 61.54%, 86.67%, and 75.00%, respectively.Conclusion: MRI and SPECT have high accuracy in detecting myocardial ischemia and necrosis and the results of the 2 methods accord well with each other.