The objective of this study was to investigate the characteristics of coronary lesions in patients with coronary heart disease complicated with hypertriglyceridemic waist phenotype and determine the relation to risk factors. For this purpose, 105 patients with ≥ 50 % stenosis in one branch of coronary arteries as confirmed by coronary angiography were enrolled. Further, in this regard, 41 cases (i.e., case group) were complicated with hypertriglyceridemic waist phenotype, while 64 patients (i.e., control group) were not complicated with this phenotype. The data show that, as compared with control group, the patients in case group had higher coronary artery scores. The coronary lesions in case group were associated with waist triglycerides index and tumor necrosis factor (TNF)-α; partial regression coefficients were 0.774 (P < 0.001) and 0.250 (P = 0.001), respectively. Therefore, it was concluded that the patients with hypertriglyceridemic waist phenotype had a worse coronary heart disease condition, whereas waist triglycerides index and TNF-α related closely to the severity of coronary lesions.