Objective: Diagnosis of coronary artery disease (CAD) in China using coronary angiography (CA) is challenging due to high disease prevalence and limited resources. It has been estimated that up to 50% of Chinese patients are negative for CAD upon CA. Coronary CT Angiography (CTA) may provide an opportunity to minimize unnecessary invasive diagnostic procedures and increase patient access to diagnosis of CAD in a cost-effective manner. This study was conducted to evaluate the potential costs and efficiency of utilizing CTA in combination with CA to optimize diagnosis and care of patients with suspected CAD in China. Methods: We conducted a cost-consequences analysis from the perspective of Fuwai Hospital in Beijing. We developed a decision-analytic model comparing a diagnostic strategy of CA only with a strategy of CTA in combination with CA for patients with low to moderate pre-test probability (based on Duke Clinical Score) of significant disease. All CA-positive patients were assumed to receive percutaneous coronary intervention (PCI). CTA diagnostic accuracy data and cost estimates were obtained from Fuwai Hospital and other inputs were derived from the published literature. Results: In the base-case analysis, assuming a CAD prevalence of 39% (range 18-64%) in the low to moderate risk patient population, utilization of CTA in combination with CA lead to a cost savings of $559 (USD) per patient (range $680-$416) compared to the CA only diagnosis strategy. The hospital cost per diagnosis of CAD was $12,483 (CTA+CA) (range $14,197-$11,900) and $13,418 (CA only) (range $17,406-$12,100), and the proportion of catheter lab diagnoses leading to PCI increased from 39% (range 18-64%) to 73% (range 48-88%). Conclusion: Our study suggests that CTA implementation in China could optimize the patient population that undergoes invasive CA procedures and provide cost-savings for Chinese hospitals.