Objective To analyze the changes of wave intensity (WI) of the left common carotid artery (LCCA) in coronary artery disease (CAD) patients with decreased left ventricular ejection fraction (LVEF). Methods Forty-one CAD patients confirmed by coronary angiography (CAG) were divided into group A, LVEF >50%, 23 cases; group B, LVEF≤50%, 18 cases. The patients included 26 males and 15 females, with an average age of (59.68±7.61) years old. Normal controls (group C) had 35 participants, including 23 males and 12 females, with an average age of (61.69±13.48) years old. All the participants underwent conventional echocardiographic examination and left common carotid WI analysis (2-D color Doppler ultrasound), and the relationship and changes of the LCCA WI values were compared between group A and group B. Results The LCCA intima-media thickness (IMT) in CAD patients were significantly thicker than that in the normal controls(P<0.05), and W1 and W2 values were significantly lower than those in the normal controls (P<0.05). The W1, W2 values in group A and group B showed a decreasing trend with the decrease of LVEF values, with W1 value of group B being significantly lower than group A (P<0.05) ; especially that, for seven participants with LVEF＜35% in group B, the W1 and W2 values were only (3.32±1.91) and (1.09±0.41) mmHg/(m·s²), respectively. Under the same arterial blood pressure level, the W1 and W2 values were positively correlated with each other in all the participants of this study (r=0.41,P＜0.05), and the W1 value was positively correlated with the LVEF (r=0.60,P＜0.05). Conclusion The W1 and W2 indices of LCCA derived from carotid WI analysis can reflect the left ventricular systolic function of CAD patients, and can serve as a valuable indicator for evaluating the peripheral hemodynamic changes.