Abstract: A three-dimensional reconstruction method for coronary vessels includes: pretreating a coronary angiography (CAG) image, extracting a vessel edge profile and two-dimensional guide wires, and dividing inner and outer membranes for intravascular ultrasound (IVUS) images; translating the two-dimensional guide wires located in a first angiography plane and a second angiography plane in the CAG image to the same starting point; building perpendicularly intersected curved surfaces; setting an intersecting line as a three-dimensional guide wire; arranging the IVUS images per frame at equal intervals along the three-dimensional guide wire; rotating the IVUS images to positions perpendicular to tangent vectors in corresponding positions; rotating the IVUS images in a vertical plane of the tangent vectors; back projecting the IVUS images to the CAG image; determining optimal orientation angles according to distances from the back projections and the vessel edge profile to the three-dimensional guide wire; and finally r