This study investigated the morphological characteristics of myocardial bridges (MBs) using optical coherence tomography (OCT) imaging compared with coronary artery angiography (CAG) and also evaluated atherosclerotic lesions in the proximal segments of MBs. Twelve patients (seven males, five females, age range 36 - 81 years) with MBs in the left anterior descending coronary artery were enrolled and examined. The mean +/- SD length of the MBs measured by OCT appeared significantly longer than when measured by CAG (20.5 +/- 4.2 mm versus 15.6 +/- 3.5 mm, respectively). The mean +/- SD maximal extent of MB stenosis appeared significantly smaller with OCT compared with CAG (48.7 +/- 4.8% versus 55.3 +/- 2.6%, respectively). Intimal thickening was observed only in the proximal 2 cm arterial segment of MBs. The morphological and intimal structure characteristics of MBs can be observed clearly with OCT.