Objective: To study the venographic characteristics of posterior ventricular vein(PVV) and explore its value in left ventricular lead implantation in cardiac resynchronization therapy(CRT). Methods: Retrograde cardiac venography with balloon through the communication branch was performed in 78 consecutive patients. Number of branches of cardiac coronary vein,the diameter of PVV,the distance of PVV to the coronary sinus ostium were measured. The pacing threshold of left ventricular lead implanted in PVV was recorded. Results: Retrograde coronary sinus venography was successfully done in all 78 patients. In average,these patients had 1.63 ± 0.49 vessel branches with diameter over 4French. PVV was seen in 40(51.3%) patients. Left ventricular leads were successfully implanted in 22(28.2%) patients in PVV. The average diameter of PVV was (2.03 ± 0.57) mm;the distance of PVV to the coronary sinus ostium was (6.73 ± 6.25) mm,with an angle of (127 ± 27.1)°. Communication branch imaging method was conducive to show PVV,ultra-elective insertion of the sheath into the PVV increased the success rate of left ventricular lead implantation. Pacing threshold of left ventricular lead in the 22 patients was (1.1 ± 0.4)V. Conclusion: The PVV joins the coronary venous near the coronary sinus ostium;communication branch imaging methods is conducive to show PVV. PVV is suitable for left ventricular lead implantation in cardiac resynchronization therapy.