Due to incompletely extracted coronary vessels and discontinuous skeleton caused by image blurring and low contrast of coronary angiogram, a multi-scale coronary segmentation and skeleton extraction method is proposed based on the Hessian matrix. Vessel radius to be estimated also lays the foundation of three-dimensional reconstruction of coronary structure. By using the relations between Hessian matrix eigenvalues and line items, a novel vesselness measure is constructed and obtain a segmented result enhancing and thresholding coronary are segmented. The normal direction of the coronary vessels is determined by the Hessian matrix, and an initial set of coronary skeleton pixels is obtained by extreme points through solving the normal direction. Therefore, Euclidean skeleton of coronary vessels are extracted. The experiment result indicates that the algorithm is concise and effective. Also it can extract more tiny branches comparing with the existing algorithms. It can get a completed coronary skeleton and estimate radius accurately.