Abstract: AIM:To explore blood uric acid, blood lipids and coronary angiographic features in young patients with acute myocardial infarction (AMI). METHODS: Data were collected and analyzed retrospectively in 42 patients (≤40 years of age) in the young group (YG) and 380 patients (>40 years of age) in the elder group (EG). Patients in both groups were diagnosed as having AMI and were treated at the Beijing Friendship Hospital from December 2007 to December 2010. RESULTS: Levels of blood uric acid (UA), triglycerides (TG) and low-density lipoprotein-cholesterol (LDL-C), body mass index (BMI), proportion of males and smokers in YG were significantly higher than those in EG. Coronary angiography showed that the incidence of one-vessel lesion in the YG was higher than that in EG (52.4% vs. 10.8%, P<0.01), but the incidence of double- and multivessel lesions in the YG was lower than that in the EG (23.8% vs. 41.3%; 21.4% vs. 47.9%, P<0.01). Multiple regression analysis showed a significant positive correlation between UA and gender, BMI, TG and glycosylated hemoglobin (HbA1c), respectively. After eliminating the influence of BMI, TG and HbA1c on the results, a significant difference in the level of blood UA was also observed between groups. CONCLUSION: The majority of young AMI patients (≤40 years) are male. The level of blood UA in young patients is higher than that in older patients. Metabolic disorders and smoking are the major risk factors for AMI prior to the age of 40 years. Young AMI patients often have milder coronary artery stenosis than elderly AMI patients.