Background <p>The uric acid to high density lipoprotein cholesterol ratio (UHR) was suggested as a parameter for assessing inflammatory status and insulin resistance, which was closely correlated with coronary artery disease. Nevertheless, the relationship between UHR and coronary slow flow phenomenon (CSFP) remains unexplored.</p> Methods <p>We consecutively recruited 1602 patients receiving coronary angiography due to chest pain and found normal coronary arteries, of whom 91 patients developed CSFP (CSFP group, <i>n</i> = 91). A 1:2 sex-and-age matched patients were selected as controls (control group, <i>n</i> = 182). The relationships between UHR and CSFP were explored.</p> Results <p>We observed that CSFP patients had an increased body mass index (BMI), uric acid and UHR, while a lower lever of high-density lipoprotein cholesterol (HDL-C) (<i>p</i> &lt; 0.05). In the CSFP patients, right coronary arteries was the most frequently affected vessels, while three coronary arteries involved in CSFP was mostly common seen. We observed that UHR was an independent predictor for CSFP (<i>p</i> &lt; 0.05). In addition, UHR suggested a higher predictive value than uric acid and HDL-C.</p> Conclusion <p>UHR was positively correlated with CSFP. As a novel indicator, UHR provided a superior predictive value for the occurrence of CSFP than single indicators. We suggested that UHR could be used a indicator for the prediction as well as and risk stratification for CSFP patients.</p>