Abstract: AIM:To compare the risk factors and severity of coronary artery lesions in patients with acute myocardial infarction (AMI) aged <60 years and >60 years. METHODS: We analyzed 200 patients with AMI admitted in our hospital from August 2012 to August 2013 retrospectively. Patients were divided into two groups: 1) aged <60 years and 2) >60 years. Risk factors, clinical test results, cardiac functions and modified Gensini scores of coronary angiography were compared between groups. RESULTS: The rates of smoking, male lipid disorder and positive family history were higher in the group <60 years of age (P<0.05 or P<0.01), whereas the rates of hypertension and stroke were lower (P<0.01). Clinical tests revealed that estimated glomerular filtration rate (eGFR), triglycerides (TG), total cholesterol (TC) and apolipoprotein B (ApoB) were significantly higher in the <60-year-old group (P<0.01). Coronary artery angiography reported a higher proportion of single vessel disease and a lower proportion of triple vessel disease in the group of <60 years of age (P<0.05 or P<0.01). The modified Gensini score was significantly lower in the group <60 years of age compared with that in the group >60 years of age. CONCLUSION: Risk factors, clinical profile and coronary artery angiography findings are different between patients <60 years and >60 years.