Objective:To evaluate relationship between different inferior wall ST-segment deviation on the initial electrocardiogram in patients with anterior wall acute myocardial infarction and lesion spite and length of anterior descending branch according to coronary arteriongraphy. Methods:According to different inferior wall ST-segment deviation, seventy-eight patients with anterior wall AM1 were divided into two groups:Group A,inferior ST-segment elevation;Group B,inferior ST-segment depression. To Compare its clinical feature and infarction related coronary artery(IRCA) between two groups. Results:As for IRCA,90.63% of group A suffered distal lesion of left anterior descending artery(LAD);80.43% of group B suffered proximal lesion of LAD. 81.25% of group A had reentry of LAD.0% of group B had reentry of LAD. Conclusion:Inferior wall ST-segment depression on the initial electrocardiogram in patients with anterior wall acute myocardial infarction indicated proximal lesion of anterior descending branch. PCI operation success rate of the group B was higher. Inferior wall ST-segment elevation in initial electrocardiogram in patients with inferior wall acute myocardial infarction indicated distal lesion of ALD and reentry of ALD.