Abstract: AIM:To evaluate the safety of bivalirudin in percutaneous coronary intervention following urokinase thrombolytic therapy. METHODS: Medical records were analyzed in the 16 patients who were given bivalirudin during emergency PCI within 3-24 h of thrombolytic therapy between October 2012 and August 2013 (bivalirudin group). The same type of records were screened where unfractionated heparin (UFH) was used during emergency PCI at a ratio of 1:2 for the control group of 32 patients based on age- and sex-matching and target coronary artery (UFH group). The main endpoint events including all-cause mortality and re-infarction and severe bleeding complications were compared between groups. RESULTS: Comparison of baseline data between groups showed no significant difference. There was one occurrence of endpoint event and one severe bleeding event within 30 days in the UFH group. The difference in the occurrence of main endpoint event and severe bleeding complication between groups was not statistically significant. CONCLUSION: Bivalirudin in percutaneous coronary intervention following urokinase thrombolytic therapy is safe.